How young for bariatric surgery in children?
This article discusses the problems obesity presents to children and their families, highlights the unique aspects of treating obesity in children, reviews the currently utilized bariatric surgical procedures, and introduces those bariatric procedures that are under development. When considering whether to use bariatric surgical procedures in a multidisciplinary weight management program for children, the special needs and characteristics of children with a severe weight problem must be considered. Development of bariatric surgical techniques and devices and implementation of these tools in multidisciplinary weight management programs need greater attention. This will require the combined efforts of the pediatric health care providers from many specialties and partnerships with industry to......
POSTED 07/01/2009 at 10:51 AM --
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Medical versus surgical interventions for the metabolic complications of obesity in children
The global epidemic of obesity has not spared children. Although prevention of obesity is commendable, we cannot hide from the pressing need to identify, assess, and actively manage children seriously afflicted by obesity and its associated conditions. Sustained weight loss (or, for children, lowering of body mass index standard deviation score) delivers major health benefit, but in children has been difficult to achieve. In adults, the success of the diabetes prevention programs using practical lifestyle interventions is indisputable. Medical therapy, although currently limited in it scope, provides some promise for older children. There is now accumulating evidence, generally of poor quality that surgical interventions (laparoscopic adjustable gastric banding and Roux-en-Y gastric bypass......
POSTED 07/01/2009 at 10:51 AM --
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Weighing risk: the Expert Committee's recommendations in practice
This article reviews recommendations on assessment of BMI, nutrition and activity, and obesity-related comorbidities. Principles of obesity prevention and treatment are discussed and high-risk eating and activity behaviors are addressed. Prevention and treatment of obesity are reviewed as set in the context of the Medical Home using the principles of the chronic disease model. The stepwise approach to obesity treatment and prevention is reviewed along with specific evidence-based/informed strategies. The skills needed to implement the recommendations, such as integration of the care team, roles and training, links to the health care system, connection to the community, and the role of the subspecialist, are discussed. (Source: Seminars in Pediatric Surgery)...
POSTED 07/01/2009 at 10:51 AM --
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Diet, exercise, behavior: the promise and limits of lifestyle change
The prevalent surge in childhood and adolescent obesity within the past 3 decades poses a significant challenge for many pediatric clinicians who are charged with treating this condition. Comprehensive, research-based pediatric obesity treatment programs are essential to addressing this problem and preventing the transition of obesity and its many comorbidities into adulthood. This paper will identify dietary, physical activity, and behavioral approaches to lifestyle change and describe how they are incorporated as part of multidisciplinary treatment interventions in youth. Specific tailoring of treatment programs to address age and varying degrees of overweight and obesity will also be presented along with recommendations for future research. (Source: Seminars in Pediatric Surgery)...
POSTED 07/01/2009 at 10:51 AM --
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Use of the metabolic syndrome in pediatrics: a blessing and a curse
The clustering of traditional cardiovascular disease risk factors is known as the metabolic syndrome. The metabolic syndrome was first characterized as a distinct entity by Dr. Gerald Reaven in 1988. The intent was to identify individuals at greatest risk for cardiovascular disease mortality and those in urgent need of lifestyle intervention. Since then the metabolic syndrome has evolved into a diagnosable entity recognized by the National Cholesterol Education Program, Adult Treatment Panel III, World Health Organization, and the International Diabetes Foundation. However, the metabolic syndrome as a diagnosis faces considerable controversy, particularly when applied to the pediatric population. Due to the changes in growth and development, the adult criteria for the metabolic syndrome ca......
POSTED 07/01/2009 at 10:51 AM --
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Changes in physiology with increasing fat mass
Obesity has reached epidemic proportions in the USA with a nearly fourfold rise in the prevalence of childhood obesity. There are many possible etiologies of obesity as the adipose tissue plays a significant, complex role in the physiology of fuel metabolism and hormone regulation. The development of obesity represents a pathophysiologic increase in fat mass in which multiple metabolic pathways are deranged. The consequences of these metabolic derangements, including insulin resistance and inflammation, are reflected in obesity-related comorbidities and can be seen in the setting of pediatric obesity. Obese adolescents demonstrate increased rates of early maturation, orthopedic growth abnormalities, diabetes mellitus, obstructive sleep apnea, hypertension, steatosis, and polycystic ovarian......
POSTED 07/01/2009 at 10:51 AM --
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Preface
Although the overall health status of the pediatric population in the United States has improved, the last quarter century has witnessed a dramatic rise in the prevalence of childhood obesity and its associated comorbid conditions. Specifically, the medical community is witnessing a steady and alarming rise in the prevalence of chronic diseases among obese children, including diabetes, hypertension, obstructive sleep apnea, hyperlipidemia, and cardiovascular disease. (Source: Seminars in Pediatric Surgery)...
POSTED 07/01/2009 at 10:51 AM --
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Contents
(Source: Seminars in Pediatric Surgery)...
POSTED 07/01/2009 at 10:51 AM --
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Potential Utility of Screening Selected Injured Children for ADHD
(Source: AAP Grand Rounds)...
POSTED 06/30/2009 at 06:00 PM --
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Male Circumcision Associated With Reduced Risk of HSV-2 and HPV
(Source: AAP Grand Rounds)...
POSTED 06/30/2009 at 06:00 PM --
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Malaria in Children Following International Travel
(Source: AAP Grand Rounds)...
POSTED 06/30/2009 at 06:00 PM --
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Dexmedetomidine vs Midazolam in Critically Ill Patients: a RCT
(Source: AAP Grand Rounds)...
POSTED 06/30/2009 at 06:00 PM --
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Maternal Thyroid Autoantibodies Predict Poor Perinatal Outcomes
(Source: AAP Grand Rounds)...
POSTED 06/30/2009 at 06:00 PM --
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Eye Abnormalities Associated With Sensorineural Hearing Loss
(Source: AAP Grand Rounds)...
POSTED 06/30/2009 at 06:00 PM --
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Risk Factors for Epilepsy After Traumatic Brain Injury
(Source: AAP Grand Rounds)...
POSTED 06/30/2009 at 06:00 PM --
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PPIs for Adults with Poorly Controlled Asthma Not Beneficial
(Source: AAP Grand Rounds)...
POSTED 06/30/2009 at 06:00 PM --
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Insulin resistance among Brazilian schoolchildren: association with risk factors for cardiovascular diseases
Conclusion: Higher levels of HOMA (IR) were positively associated with risk factors for CVD among schoolchildren. (Source: Acta Paediatrica)...
POSTED 06/30/2009 at 06:00 PM --
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Visual Diagnosis: Large Neck and Chest Mass in a Newborn (Click here)
(Source: NeoReviews recent issues)...
POSTED 06/30/2009 at 06:00 PM --
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Strip of the Month: July 2009
(Source: NeoReviews recent issues)...
POSTED 06/30/2009 at 06:00 PM --
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Index of Suspicion in the Nursery
(Source: NeoReviews recent issues)...
POSTED 06/30/2009 at 06:00 PM --
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