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Pediatric bariatric

Maria Grazia Clemente, Claudia Mandato, Marco Poeta, Pietro Vajro
Non-alcoholic fatty liver disease (NAFLD) in children is becoming a major health concern. A "multiple-hit" pathogenetic model has been suggested to explain the progressive liver damage that occurs among children with NAFLD. In addition to the accumulation of fat in the liver, insulin resistance (IR) and oxidative stress due to genetic/epigenetic background, unfavorable lifestyles, gut microbiota and gut-liver axis dysfunction, and perturbations of trace element homeostasis have been shown to be critical for disease progression and the development of more severe inflammatory and fibrotic stages [non-alcoholic steatohepatitis (NASH)]...
September 28, 2016: World Journal of Gastroenterology: WJG
Nicole Coles, Catherine Birken, Jill Hamilton
Severe obesity in childhood is increasing in prevalence and is associated with considerable morbidity. Studies into pediatric obesity have focused largely on interventions that do not necessarily target the unique biologic or psychological underpinnings for the weight gain in the individual child or adolescent. Outcomes show modest improvement and are of questionable benefit for patients with severe obesity. Although weight is a commonly used outcome, other psychological and metabolic parameters including normalization of physical activity and eating behaviors should be primary outcome goals...
September 29, 2016: BMJ: British Medical Journal
Stacey Ishman, Christine Heubi, Todd Jenkins, Marc Michalsky, Narong Simakajornboon, Thomas Inge
OBJECTIVE: Obstructive sleep apnea (OSA) is reported in 70% of adolescents who present for bariatric surgery. The Pediatric Sleep Questionnaire (PSQ) was developed to identify children at risk for OSA but is not validated in adolescents with obesity. The aims of this study were: (1) to assess validity of the PSQ to detect OSA and (2) to determine the correlation between anthropometric and polysomnography measurements. METHODS: A cross-sectional assessment of Teen-Longitudinal Assessment of Bariatric Surgery participants at high risk for OSA was performed...
November 2016: Obesity
Nirav K Desai, Mark L Wulkan, Thomas H Inge
Childhood obesity remains a significant public health issue. Approximately 8% of adolescent girls and 7% of adolescent boys have severe (≥class 2) obesity. Adolescent severe obesity is associated with numerous comorbidities, and persists into adulthood. Bariatric surgery is the most effective treatment available, resulting in major weight loss and resolution of important comorbid conditions. Clinical practice guidelines for pediatric obesity treatment recommend consideration of surgery after failure of behavioral approaches...
September 2016: Endocrinology and Metabolism Clinics of North America
Camilla Virili, Pierpaolo Trimboli, Francesco Romanelli, Marco Centanni
Levothyroxine is recognized as the treatment of choice for hypothyroidism. So far, the tablet levothyroxine has been the formulation almost exclusively used, even though an optimal daily dose of levothyroxine has been unsuccessfully sought and a consensus not achieved. Due to progressive use of a more individually tailored levothyroxine dose, increasing evidence has instead displayed that many gastrointestinal disorders, polypharmacy, and food interference may raise the daily levothyroxine requirement. In recent years, alternative levothyroxine formulations have become available and have rapidly gained attention because of their pharmacokinetic properties...
July 29, 2016: Endocrine
Kuan-Wen Wang, Marlie Valencia, Laura Banfield, Ruth Chau, Adam Fleming, Sheila K Singh, Sarah Burrow, Russell J de Souza, Lehana Thabane, M Constantine Samaan
BACKGROUND: Pediatric brain tumors are the most common solid tumors in children. Advances in understanding the hallmarks of cancer biology and novel therapies have led to an increasing number of survivors of childhood brain tumors (SCBT). However, these survivors are at an increased risk of obesity and cardiometabolic disorders that affect their quality of life and lifespan. It is important to define effective strategies to treat and prevent obesity in this population. This systematic review aims to investigate the effectiveness of lifestyle interventions, pharmacotherapy, and bariatric surgery on treating obesity in SCBT...
2016: Systematic Reviews
Dzmitry M Fursevich, Gary M LiMarzi, Matthew C O'Dell, Manuel A Hernandez, William F Sensakovic
The obesity epidemic in the adult and pediatric populations affects all aspects of health care, including diagnostic imaging. With the increasing prevalence of obese and morbidly obese patients, bariatric computed tomographic (CT) imaging is becoming common in day-to-day radiology practice, and a basic understanding of the unique problems that bariatric patients pose to the imaging community is crucial in any setting. Because larger patients may not fit into conventional scanners, having a CT scanner with an adequate table load limit, a large gantry aperture, a large scan field of view, and a high-power generator is a prerequisite for bariatric imaging...
July 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Paul J Samuels, Matthew D Sjoblom
PURPOSE OF REVIEW: Pediatric obesity has become commonplace in our clinical practice, and presents anesthesia providers with numerous challenges. This study provides an up-to-date review of their perioperative care, including the measurement of pediatric obesity, rational drug dosing in obese children, and recent data on bariatric outcomes in adolescents. RECENT FINDINGS: Pediatric obesity is associated with a number of relevant comorbidities that impact anesthesia care, and specific children are at particularly high risk...
June 2016: Current Opinion in Anaesthesiology
Nicole M Schneider, Carrie B Tully, Gia A Washington, Karin L Price
BACKGROUND: Bariatric surgery is an invasive medical treatment for morbid obesity that requires behavioral maintenance for physical success. Patient knowledge, motivation, and adherence are important factors in optimizing results. OBJECTIVES: The purpose of the present study was to identify perceived informational gaps of adolescent and young adult bariatric surgery patients with morbid obesity (body mass index≥40 kg/m(2)). SETTING: This study took place in a pediatric tertiary care academic medical center...
May 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Shumei Xu, Ying Xue
Pediatric or childhood obesity is the most prevalent nutritional disorder among children and adolescents worldwide. Approximately 43 million individuals are obese, 21-24% children and adolescents are overweight, and 16-18% of individuals have abdominal obesity. The prevalence of obesity is highest among specific ethnic groups. Obesity increases the risk of heart diseases in children and adults. Childhood obesity predisposes the individual to insulin resistance and type 2 diabetes, hypertension, hyperlipidemia, liver and kidney diseases and causes reproductive dysfunction in adults...
January 2016: Experimental and Therapeutic Medicine
Marissa A Gowey, Jennifer Reiter-Purtill, Jennifer Becnel, James Peugh, James E Mitchell, Meg H Zeller
OBJECTIVE: Severe obesity is the fastest growing pediatric subgroup of excess weight levels. Psychological dysregulation (i.e., impairments in regulating cognitive, emotional, and/or behavioral processes) has been associated with obesity and poorer weight loss outcomes. The present study explored associations of dysregulation with weight-related variables among adolescent and young adult (AYA) females with severe obesity. METHODS: Fifty-four AYA females with severe obesity (MBMI = 48...
April 1, 2016: Appetite
Abduh Elbanna, Mohammed Tag Eldin, Mohammad Fathy, Osama Osman, Mohammed Abdelfattah, Abdelrahman Safwat, Mohammed Sedki Abd Elkader, Shymaa E Bilasy, Khaled Salama, Asim A Elnour, Abdullah Shehab, Shazly Baghdady, Mohamed Amer, Mohamed Alboraie, Aly Ragb, Abd Elrazek Abd Elrazek
Children obesity has become one of the most important public health problems in many countries worldwide. Although the awareness of childhood obesity as a modifiable health risk is high, but many societies do not prioritize this issue as a health care problem, which may lead to comorbidities and even premature death. Despite the rising interest in bariatric surgery for children, only laparoscopic sleeve gastrectomy (LSG) is being considered in resolving childhood obesity who failed other dietary or drug therapies; however many of LSG procedures failed to reduce the weight in children or resulted in complications postsurgery...
December 2015: Medicine (Baltimore)
Debopam Samanta
In recent times, pediatric obesity has become widely prevalent. If first-line treatment with lifestyle modification fails, bariatric surgery may be indicated for severely obese patients. Many patients now travel abroad to get these surgeries done. Some of these patients receive inadequate postoperative care. We described a morbidly obese 17-year-old girl who had a laparoscopic sleeve gastrectomy procedure for weight loss. Due to severe nausea, she stopped her multivitamin supplementation. Within a few weeks, she developed symptoms of dry beriberi was soon followed by classic symptoms of Wernicke's encephalopathy...
July 2015: Journal of Pediatric Neurosciences
E B Jelin, H Daggag, A L Speer, N Hameed, N Lessan, M Barakat, E P Nadler
Homozygous or compound heterozygous melanocortin-4 receptor (MC4R) mutations are rare with fewer than 10 patients described in current literature. Here we report the short- and long-term outcomes for four children ages 4.5-14 who are homozygous for loss-of-function mutations in the MC4R and underwent laparoscopic sleeve gastrectomy. All four patients experienced significant weight loss and improvement in, or resolution of, their comorbidities in the short term. One patient, however, has had significant weight regain in the long term...
March 2016: International Journal of Obesity: Journal of the International Association for the Study of Obesity
A-C Paepegaey, B Dubern, A Karsenty, H Chantereau, J Aron-Wisnewsky, L Oderda, M Hadoux, A Robert-Gary, J-L Bouillot, J-M Oppert, P Tounian, C Poitou
INTRODUCTION: In young obese patients, the transition from adolescence to adulthood, i.e., the transition from the pediatric to the adult medical team, is a new issue. In particular, it is important to define when and how this transition should be made in the setting of bariatric surgery. MATERIALS AND METHODS: Fourteen young obese patients (under the age of 20), who underwent bariatric surgery, were included in the study (nine cases of Roux-en-Y gastric by-pass, three sleeve gastrectomy, one gastric banding)...
December 2015: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Françoise Schmitt, Elise Riquin, Marion Beaumesnil, Mickaël Dinomais, Philippe Topart, Dominique Weil, Jean Malka, Régis Coutant, Guillaume Podevin, Natacha Bouhours-Nouet
BACKGROUND/PURPOSE: Obesity now affects 3%-4% of the pediatric population and contributes to the increase in cardiac mortality in adulthood. Bariatric surgery is the best treatment for weight loss and the obesity-associated comorbidities in adults. We report here our experience of laparoscopic adjustable gastric banding (LAGB) in adolescents. METHODS: The medical charts of the first 16 patients operated on in our center were reviewed. Data were compiled concerning weight loss, physical and biological comorbidities, health-related quality of life (QOL) and surgical complications before surgery and during 24months of follow-up...
March 2016: Journal of Pediatric Surgery
Janelle D Vaughns, Victoria C Ziesenitz, John N van den Anker
Obesity represents one of the most important public health issues according to the World Health Organization. Additionally, in a recent National Health and Nutrition Survey of 2011-2012, approximately 17 % of children and adolescents in the United States were considered obese. The obesity rate is higher within the adolescent age group as compared to preschool children. Childhood obesity is particularly problematic, because the co-morbid disease states which accompany obesity may require frequent pharmacotherapy and/ or surgical intervention...
2015: Current Pharmaceutical Design
Nicole L Mihalopoulos, Michael G Spigarelli
PURPOSE: The purpose of this article is to provide a review of the existing literature for the comanagement of depression and obesity in the pediatric population. METHODS: A review of the current literature was conducted using EBSCOhost and EMBASE to identify evidence and recommendations for the comanagement of depression and obesity among children and adolescents (aged 2-18 years). Additional search criteria included peer-reviewed, English language-only full-text articles published before August 2015...
September 1, 2015: Clinical Therapeutics
Arnaud Basdevant
Bariatric surgery in teen-agers is increasing. This surgical option in the severely obese adolescent raises a series of questions on clinical pathway and ethics. It should be realized in highly specialized centers gathering skills in bariatric surgery, pediatric endocrinology and nutrition and psychology. It is a longstanding multifocal and proactive management including the transition to adulthood. Expert centers should be identified.
June 2015: La Revue du Praticien
Rajan K Thakkar, Marc P Michalsky
PURPOSE OF REVIEW: Recent evidence highlighting the prevalence of severe obesity in the pediatric population, coupled with disappointing outcomes related to medical weight loss interventions, has led to increased interest in bariatric surgery. This article focuses on recent additions to the literature regarding the current indications and outcomes of adolescent bariatric surgery, emerging guidelines on the development of surgical weight loss programs and the status of access to bariatric surgical care for adolescents in the United States...
June 2015: Current Opinion in Pediatrics
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