scholarly journals Metabolic and Bariatric Surgery in Adolescents

2021 ◽  
Author(s):  
Christopher G. Chalklin ◽  
Elizabeth G. Ryan Harper ◽  
Andrew J. Beamish
Keyword(s):  
Bariatric Surgery ◽  
Mental Health Problems ◽  
Age Groups ◽  
Current Evidence ◽  
Future Studies ◽  
Limited Success ◽  
Prevalence Of Obesity ◽  
Metabolic And Bariatric Surgery ◽  
Comorbidity Resolution

Abstract Purpose of Review The prevalence of obesity is increasing in all age groups. Following its success in adults, and with limited success using conservative therapies, metabolic and bariatric surgery (MBS) is increasingly being utilized in adolescents. This review highlights the current evidence and guidelines supporting its use. Recent Findings Safety and efficacy mirror results seen in adults. The most recent evidence, as outcomes enter the long term, suggests that comorbidity resolution, including diabetes and hypertension, can even outperform that of adults. Mental health problems persist despite good weight loss. Overall, the positive early weight and comorbidity outcomes are well sustained into the long term. Summary There is a growing need to prevent and treat adolescent obesity. Current evidence supports the use of MBS in adolescents. Ongoing and future studies will provide 10-year outcomes and assist in the refinement of multimodal pathways incorporating MBS for the treatment of severe childhood obesity.

scholarly journals Long-Term Quality of Life Outcomes After Laparoscopic Sleeve Gastrectomy and Roux-en-Y Gastric Bypass—a Comparative Study

2020 ◽  
Author(s):  
Cristina Fiorani ◽  
Sophie R. Coles ◽  
Myutan Kulendran ◽  
Emma Rose McGlone ◽  
Marcus Reddy ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Metabolic Effects ◽  
Life Outcomes ◽  
Post Bariatric Surgery ◽  
Comorbidity Resolution

Abstract Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) have been shown to improve metabolic comorbidities as well as quality of life (QoL) in the obese population. The vast majority of previous studies have investigated the metabolic effects of bariatric surgery and there is a dearth of studies examining long-term QoL outcomes post bariatric surgery. The outcomes of 43 patients who underwent bariatric surgery were prospectively assessed, using BAROS questionnaires to quantify QoL and metabolic status pre-operatively, at 1 year and at 8 years. Total weight loss and comorbidity resolution were similar between RYGB and SG. The RYGB cohort experienced greater QoL improvement from baseline and had higher BAROS scores at 8 years. RYGB may provide more substantial and durable long-term benefits as compared to SG.

scholarly journals Pathophysiology Underpinning Gestational Diabetes Mellitus and the Role of Biomarkers for its Prediction

EMJ Diabetes ◽  
2020 ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Current Evidence ◽  
Diagnostic Strategies ◽  
Prevalence Of Obesity ◽  
Maternal And Neonatal Outcomes ◽  
Potential Biomarkers

Gestational diabetes mellitus (GDM) is a frequent complication of pregnancy, with an increasing incidence that has been attributed to an ageing maternal population, an increasing prevalence of obesity, and alterations in diagnostic criteria. The consequences of GDM are far-reaching and impact both the mother and their offspring. It is associated with poor maternal and neonatal outcomes compared with non-GDM pregnancies. Furthermore, it is associated with long-term poor metabolic health in both mother and offspring. Current diagnostic strategies centre on clinical risk factors, however these can lack specificity. This has spurred investigations into identifying potential biomarkers to aid in diagnosis and risk stratification. In this review, the current evidence around potential biomarkers, their role in understanding pathophysiologic pathways for GDM development, and the possibility of their use in clinical practice is explored.

scholarly journals Current Views on the Use of Bariatric Surgery in Patients with Extreme Obesity

2020 ◽  
Vol 13 (3) ◽  
pp. 262-267
Author(s):  
Aleksandra Mitsinskaya ◽  
Victor Kaschenko ◽  
Mikhail Fishman ◽  
Alexey Sokolov ◽  
V. S. Samoilov ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Surgical Treatment ◽  
Preoperative Preparation ◽  
Extreme Obesity ◽  
Super Obesity ◽  
One Stage ◽  
Combined Operations ◽  
The World ◽  
Prevalence Of Obesity

Currently, the prevalence of obesity and its extreme forms is progressively increasing throughout the world. The article presents analysis of different approaches to the surgical treatment of super and super-super obesity. The range of methods varies from one-stage restrictive interventions to the use of multi-component combined operations with long-term preoperative preparation. In general, the opinions of the experts seem to be different, so at the present time there are no uniform recommendations for treating patients with extreme obesity, the fact determining the need for further research

scholarly journals Maternal Psychological Distress & Mental Health Service Use during the COVID-19 Pandemic

2020 ◽  
Author(s):  
Emily E Cameron ◽  
Kayla M. Joyce ◽  
Chantal P Delaquis ◽  
Kristin Reynolds ◽  
Jennifer Protudjer ◽  
...  
Keyword(s):  
Mental Health ◽  
Service Use ◽  
Mental Health Problems ◽  
Age Groups ◽  
Well Being ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Depression And Anxiety ◽  
Child Age

Background: Mental health problems are increasingly recognized as a significant and concerning secondary effect of the COVID-19 pandemic. Research on previous epidemics/pandemics suggest that families, particularly mothers, may be at increased risk, but this population has yet to be examined. The current study (1) described prevalence rates of maternal depressive and anxiety symptoms from an online convenience sample during the COVID-19 pandemic, (2) identified risk and protective factors for elevated symptoms, and (3) described current mental health service use and barriers. Methods: Participants (N = 641) were mothers of children age 0-8 years, including expectant mothers. Mothers completed an online survey assessing mental health, sociodemographic information, and COVID-19-related variables. Results: Clinically-relevant depression was indicated in 33.16%, 42.55%, and 43.37% of mothers of children age 0-18 months, 18 months to 4 years, and 5 to 8 years, respectively. Prevalence of anxiety was 36.27%, 32.62%, and 29.59% for mothers across age groups, respectively. Binary logistic regressions indicated significant associations between risk factors and depression/anxiety across child age groups. Limitations: Cross-sectional data was used to describe maternal mental health problems during COVID-19 limiting the ability to make inferences about the long-term impact of maternal depression and anxiety on family well-being. Conclusions: Maternal depression and anxiety appear to be elevated in the context of COVID-19 compared to previously reported population norms. Identified risk factors for depression and anxiety across different child age ranges can inform targeted early intervention strategies to prevent long-term impacts of the COVID-19 pandemic on family well-being and child development.

scholarly journals Treatment of MIS-C in Children and Adolescents

2022 ◽  
Author(s):  
Sanaa Mahmoud ◽  
Mostafa El-Kalliny ◽  
Alyaa Kotby ◽  
Mona El-Ganzoury ◽  
Eman Fouda ◽  
...  
Keyword(s):  
Management Strategies ◽  
Biologic Agents ◽  
Current Evidence ◽  
Long Term Outcomes ◽  
Thrombotic Risk ◽  
Future Studies ◽  
Management Plans ◽  
Short And Long Term ◽  
Inflammatory Syndrome

Abstract Purpose of Review Different treatment approaches have been described for the management of COVID-19-related multisystem inflammatory syndrome in children (MIS-C), the pathogenesis of which has not yet been fully elucidated. Here, we comprehensively review and summarize the recommendations and management strategies that have been published to date. Recent Findings MIS-C patients are treated with different regimens, mostly revolving around the use of immunomodulatory medications, including IVIG and glucocorticoids as first-tier therapy. Refractoriness to IVIG and glucocorticoids warrants a step-up of immunomodulatory therapy to biologic agents such as anakinra, tocilizumab, and infliximab. Summary We review the current evidence regarding the use of monotherapy versus combination therapy, as well as the current recommendations for assessing thrombotic risk and administering antiplatelet and anticoagulant therapy. We anticipate that future studies will provide evidence for management plans that maximize short- and long-term outcomes.

Biliary Complications of Bariatric Surgery

2018 ◽  
Author(s):  
Ricard Corcelles ◽  
Jeffrey L. Ponsky
Keyword(s):  
Bariatric Surgery ◽  
Expectant Management ◽  
Public Health Problem ◽  
Gallstone Formation ◽  
Biliary Complications ◽  
Current Evidence ◽  
Major Public Health Problem ◽  
Prophylactic Cholecystectomy ◽  
Pharmacologic Prophylaxis

Obesity is a major public health problem associated with significant morbidity and mortality. Obesity is also a well-known risk factor for gallstone formation. Bariatric surgery is the most effective therapy for morbid obesity; however, the metabolic alterations it imparts can cause specific mid- or long-term complications, such as biliary lithiasis. The rate of development of cholelithiasis after bariatric surgery has been reported to be around 32% to 42% with studies ranging from 2–52% depending on use of pharmacologic prophylaxis. Therefore, prophylactic cholecystectomy during gastric bypass was historically recommended in the era of open surgery. The current management of gallbladder pathology remains a point of contention, ranging from prophylactic cholecystectomy, to cholecystectomy in the setting of biliary symptoms or presence of stones on preoperative ultrasound, to expectant management. This chapter discusses the current evidence regarding biliary complications and management in bariatric surgery.

The 1993 Borden Award Lecture. Fatty acid requirements of the newborn

1994 ◽  
Vol 72 (12) ◽  
pp. 1483-1492 ◽  
Author(s):  
Sheila M. Innis
Keyword(s):  
Fatty Acids ◽  
Arachidonic Acid ◽  
Fatty Acid ◽  
Docosahexaenoic Acid ◽  
Essential Fatty Acids ◽  
Learning Ability ◽  
Current Evidence ◽  
Fatty Acid Transport ◽  
Future Studies

Arachidonic acid (20:4ω−6) and docosahexaenoic acid (22:6ω−3) are deposited in large amounts in the nonmyelin membranes of the developing central nervous system (CNS). Inadequate supplies of ω−6 and ω−3 fatty acids during CNS development are of concern because of possible long-term changes in learning ability and reduced visual function. Although all of the ω−6 and ω−3 fatty acids in the CNS are ultimately derived from the diet, the pathways for transport or transfer from the plasma to the CNS are not known. Current evidence suggests that the newborn is able to synthesize 20:4ω−6 and 22:6ω−3 from linoleic acid (18:2ω−6) and linolenic acid (18:3ω−3), respectively; however, it is not yet clear if synthesis occurs in the liver prior to transfer to the CNS, or directly in the CNS. Further understanding of the roles of 20:4ω−6 and 22:6ω−3 in CNS metabolism, pathways of ω−6 and ω−3 fatty acid transport and CNS uptake, and the effects of premature birth on fatty acid metabolism is needed to facilitate future studies on the importance of 20:4ω−6 and 22:6ω−3 in infant nutrition.Key words: brain development, essential fatty acids, docosahexaenoic acid, arachidonic acid, human milk, infant formula.

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