DOCSLIB.ORG

OBESITY and Treatment Essentials

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
OBESITY and Treatment Essentials EvaluationOBESITY and Treatment Essentials Copyright 2016 From Obesity: Evaluation and Treatment Essentials, Second Edition by Michael Steelman. Reproduced by permission of Taylor and Francis Group, LLC, a division of Informa plc. This material is strictly for the intended use only. For any other use, the user must contact Taylor & Francis directly at this address: [email protected]. Printing, photocopying, sharing via any means is a violation of copyright. Copyright 2016 From Obesity: Evaluation and Treatment Essentials, Second Edition by Michael Steelman. Reproduced by permission of Taylor and Francis Group, LLC, a division of Informa plc. This material is strictly for the intended use only. For any other use, the user must contact Taylor & Francis directly at this address: [email protected]. Printing, photocopying, sharing via any means is a violation of copyright. SECOND EDITION EvaluationOBESITY and Treatment Essentials Copyright 2016 Edited by From Obesity: EvaluationG. and Michael Treatment Steelman, Essentials, MD, Second FASBP Edition by Michael Steelman. Reproduced by permissionAmerican of Taylor Society and Francis of Bariatric Group, Physicians LLC, a division of Informa plc. This material is strictly for the intendedThe use Steelman only. Clinic Oklahoma City, Oklahoma, USA For any other use, the user must contact Taylor & Francis directly at this address: [email protected] C. Westman, MD, MHS Lifestyle Medicine Clinic Printing, photocopying, sharingDuke via any University means Medical is a violation Center of copyright. Durham, North Carolina, USA CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2016 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Printed on acid-free paper Version Date: 20160229 International Standard Book Number-13: 978-1-4822-6207-0 (Pack - Book and Ebook) This book contains information obtained from authentic and highly regarded sources. While all reasonable efforts have been made to publish reliable data and information, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors Copyrightor omissions 2016 that may be made. The publishers wish to make clear that any views or opinions expressed in this book by individual editors, authors or contributors are personal to them and do not necessarily reflect the views/opinions of the publishers. The information or guid- ance contained in this book is intended for use by medical, scientific or health-care professionals and is provided strictly as a supplement to the medical or other professional’s own judgement, their knowledge of the patient’s medical history, relevant manufacturer’s instructions Fromand theObesity: appropriate Evaluation best practice guidelines. and TreatmentBecause of the rapid Essentials, advances in medical Second science, Editionany information by orMichael advice on dosages, Steelman. pro- Reproducedcedures or diagnoses by shouldpermission be independently of Taylor verified. Theand reader Francis is strongly Group, urged to consult LLC, the a relevant division national of drug Informa formulary andplc. the drug companies’ and device or material manufacturers’ printed instructions, and their websites, before administering or utilizing any of the Thisdrugs, material devices or materialsis strictly mentioned for thein this intended book. This book use does only.not indicate whether a particular treatment is appropriate or suitable for a particular individual. Ultimately it is the sole responsibility of the medical professional to make his or her own professional judgements, so as to advise and treat patients appropriately. The authors and publishers have also attempted to trace the copyright holders of all material Forreproduced any other in this use,publication the and user apologize must to copyright contact holders Taylor if permission & Francis to publish directlyin this form athas notthis been address: obtained. If any copy- [email protected] material has not been acknowledged please write and let us know so we may rectify in any future reprint. Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in Printing,any information photocopying, storage or retrieval sharing system, without via writtenany means permission isfrom a theviolation publishers. of copyright. For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organization that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Library of Congress Cataloging-in-Publication Data Names: Steelman, G. Michael, editor. | Westman, Eric C., editor. Title: Obesity : evaluation and treatment essentials / [edited by] G. Michael Steelman, Eric C. Westman. Other titles: Obesity (Steelman) Description: Second edition. | Boca Raton : Taylor & Francis, 2016. | Includes bibliographical references and index. Identifiers: LCCN 2015039007 | ISBN 9781482262070 (alk. paper) Subjects: | MESH: Obesity--therapy. | Obesity--prevention & control. Classification: LCC RC628 | NLM WD 210 | DDC 616.3/98--dc23 LC record available at http://lccn.loc.gov/2015039007 Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com Contents Foreword vii Preface to the first edition ix Preface to the second edition xi Contributors xiii Editors xv Copyright 2016 1 Obesity: The scope of a growing problem 1 From Obesity:Harold Evaluation C. Seim and Treatment Essentials, Second Edition by Michael Steelman. 2 Etiologies of obesity 7 ReproducedLarry by permissionA. Richardson of Taylor and Francis Group, LLC, a division of Informa plc. This material 3 Health is strictly hazards for of the obesity intended use only. 47 G. Michael Steelman For any 4 other Evaluation use, the of userthe obese must patient contact Taylor & Francis directly at this address: 69 [email protected]. Michael Steelman and James T. Cooper 5 Dietary treatment of overweight and obesity 83 Printing, photocopying,Eric C. Westman, sharing Mary C. via Vernon, any means and James is a A. violation Wortman of copyright. 6 The role of physical activity in the treatment of overweight and obesity 101 Deborah Bade Horn 7 Behavioral modification 123 Erin Chamberlin-Snyder 8 Pharmacotherapy 137 Ed J. Hendricks 9 Maintenance of weight loss 169 Scott Rigden 10 Surgical treatment of the obese individual 181 John B. Cleek and Eric C. Westman 11 Medical treatment of pediatric overweight and obesity 195 Eric C. Westman 12 Binge eating disorder: Etiology, assessment, diagnosis, and treatment 205 Ralph Carson 13 Current research and future hope 253 Frank L. Greenway and Steven R. Smith v vi Contents Appendix A: Notes on nutrition for obesity medicine 283 Jeffrey D. Lawrence Appendix B: Behavioral modification attachments 299 Appendix C: ASBP algorithm 323 Index 329 Copyright 2016 From Obesity: Evaluation and Treatment Essentials, Second Edition by Michael Steelman. Reproduced by permission of Taylor and Francis Group, LLC, a division of Informa plc. This material is strictly for the intended use only. For any other use, the user must contact Taylor & Francis directly at this address: [email protected]. Printing, photocopying, sharing via any means is a violation of copyright. Foreword Obesity, the word itself doesn’t conjure up many positive emotions from people at large, or from busy doctors. Perhaps being fat was a good thing in the year ad 1000 when our ancestors were running around, and when there were no supermarkets on the corners. Who survived when there was a famine and passed their gene pools down to us? Generally, it wasn’t the skinny ones. Significant corpulence was out of vogue by the 1860s, at the time of our Civil War. William Banting, a 5′ 5′′, 202-lb undertaker in merry old England tried nearly everything to Copyrightlose weight2016 without much success. A hearing problem led him to see Dr. William Harvey, an ear, nose, and throat doctor of some renown. Dr. Harvey thought Banting’s hearing problem From Obesity:might be Evaluationrelated to his and obesity Treatment and suggested Essentials, a reduced Second carbohydrate Edition diet by (with Michael still aSteelman. few spirits allowed). Low-carbohydrate diets were used to treat diabetes in the pre-insulin era. Reproduced by permission of Taylor and Francis Group, LLC, a division of Informa plc. Following this eating plan, Banting lost weight nicely and kept it off. He was so happy that he This materialwrote and is distributedstrictly for a thepamphlet intended about use his success.only. This stirred up considerable discussion at the time, and, by the early 1900s, some
Load more

Recommended publications
  • Maternal Overnutrition Programs Hedonic and Metabolic Phenotypes Across Generations Through Sperm Tsrnas
    Maternal overnutrition programs hedonic and metabolic phenotypes across generations through sperm tsRNAs Gitalee Sarkera, Wenfei Suna, David Rosenkranzb, Pawel Pelczarc, Lennart Opitzd, Vissarion Efthymioua, Christian Wolfruma, and Daria Peleg-Raibsteina,1 aLaboratory of Translational Nutrition Biology, Department of Health Sciences and Technology, ETH Zurich, 8603 Schwerzenbach, Switzerland; bInstitute of Anthropology, Johannes Gutenberg University Mainz, 55099 Mainz, Germany; cCenter for Transgenic Models, University of Basel, 3350 Basel, Switzerland; and dFunctional Genomics Center Zurich, ETH Zurich, 8057 Zurich, Switzerland Edited by Nathaniel Heintz, The Rockefeller University, New York, NY, and approved April 11, 2019 (received for review December 10, 2018) There is a growing body of evidence linking maternal overnutri- altered hedonic and obesogenic phenotypes (12, 13). Similar to tion to obesity and psychopathology that can be conserved across other early nutritional animal models, we have observed only multiple generations. Recently, we demonstrated in a maternal moderate changes in CpG methylation in F1 (first-generation) high-fat diet (HFD; MHFD) mouse model that MHFD induced and F2 (second-generation) sperm between the offspring groups enhanced hedonic behaviors and obesogenic phenotypes that (13–15). This suggests that sperm methylome might not constitute were conserved across three generations via the paternal lineage, the principal mode of transmission of these phenotypes. which was independent of sperm methylome changes. Here, we Although changes in DNA methylation pattern and histone show that sperm tRNA-derived small RNAs (tsRNAs) partly contrib- modifications have been reported following a range of early-life ute to the transmission of such phenotypes. We observe increased environmental exposures (14, 16–19), a causal link between the expression of sperm tsRNAs in the F1 male offspring born to HFD- germ cell epigenetic marks and the observed phenotypes in the exposed dams.
    [Show full text]
  • Obesity: Surgical and Pharmaceutical Options & Navigating Diet Trends
    Obesity: Surgical and Pharmaceutical options & Navigating diet trends Guillermo Higa MD, FACS, FASMBS Bariatric Surgery Medical Director Chief of Division of Bariatric Surgery St. Mary’s Hospital Tucson-Arizona What is Obesity? The Obesity Medicine Association Definition of Obesity • “Obesity is defined as a chronic, relapsing, multi-factorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences.” Obesity Algorithm®. ©2017-2018 Obesity Medicine Association. Obesity is common, serious, and costly • The prevalence of obesity was 39.8% and affected about 93.3 million of US adults in 2015-2016. • Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer that are some of the leading causes of preventable, premature death. • The estimated annual medical cost of obesity in the United States was $147 billion in 2008 US dollars; the medical cost for people who have obesity was $1,429 higher than those of normal weight. https://www.cdc.gov/obesity/data/adult.html Obesity Kills • Leading cause of preventable death • Recently surpassed smoking as leading cause • Lifespan shortened 9 - 12 years • Over 400,000 deaths per year • 46 deaths each hour Prevalence of Self-Reported Obesity Among U.S. Adults by State and Territory, BRFSS, 2017 ¶ Prevalence estimates reflect BRFSS methodological changes started in 2011. These estimates should not be compared
    [Show full text]
  • The National Drugs List
    ^ ^ ^ ^ ^[ ^ The National Drugs List Of Syrian Arab Republic Sexth Edition 2006 ! " # "$ % &'() " # * +$, -. / & 0 /+12 3 4" 5 "$ . "$ 67"5,) 0 " /! !2 4? @ % 88 9 3: " # "$ ;+<=2 – G# H H2 I) – 6( – 65 : A B C "5 : , D )* . J!* HK"3 H"$ T ) 4 B K<) +$ LMA N O 3 4P<B &Q / RS ) H< C4VH /430 / 1988 V W* < C A GQ ") 4V / 1000 / C4VH /820 / 2001 V XX K<# C ,V /500 / 1992 V "!X V /946 / 2004 V Z < C V /914 / 2003 V ) < ] +$, [2 / ,) @# @ S%Q2 J"= [ &<\ @ +$ LMA 1 O \ . S X '( ^ & M_ `AB @ &' 3 4" + @ V= 4 )\ " : N " # "$ 6 ) G" 3Q + a C G /<"B d3: C K7 e , fM 4 Q b"$ " < $\ c"7: 5) G . HHH3Q J # Hg ' V"h 6< G* H5 !" # $%" & $' ,* ( )* + 2 ا اوا ادو +% 5 j 2 i1 6 B J' 6<X " 6"[ i2 "$ "< * i3 10 6 i4 11 6! ^ i5 13 6<X "!# * i6 15 7 G!, 6 - k 24"$d dl ?K V *4V h 63[46 ' i8 19 Adl 20 "( 2 i9 20 G Q) 6 i10 20 a 6 m[, 6 i11 21 ?K V $n i12 21 "% * i13 23 b+ 6 i14 23 oe C * i15 24 !, 2 6\ i16 25 C V pq * i17 26 ( S 6) 1, ++ &"r i19 3 +% 27 G 6 ""% i19 28 ^ Ks 2 i20 31 % Ks 2 i21 32 s * i22 35 " " * i23 37 "$ * i24 38 6" i25 39 V t h Gu* v!* 2 i26 39 ( 2 i27 40 B w< Ks 2 i28 40 d C &"r i29 42 "' 6 i30 42 " * i31 42 ":< * i32 5 ./ 0" -33 4 : ANAESTHETICS $ 1 2 -1 :GENERAL ANAESTHETICS AND OXYGEN 4 $1 2 2- ATRACURIUM BESYLATE DROPERIDOL ETHER FENTANYL HALOTHANE ISOFLURANE KETAMINE HCL NITROUS OXIDE OXYGEN PROPOFOL REMIFENTANIL SEVOFLURANE SUFENTANIL THIOPENTAL :LOCAL ANAESTHETICS !67$1 2 -5 AMYLEINE HCL=AMYLOCAINE ARTICAINE BENZOCAINE BUPIVACAINE CINCHOCAINE LIDOCAINE MEPIVACAINE OXETHAZAINE PRAMOXINE PRILOCAINE PREOPERATIVE MEDICATION & SEDATION FOR 9*: ;< " 2 -8 : : SHORT -TERM PROCEDURES ATROPINE DIAZEPAM INJ.
    [Show full text]
  • Optimal Resources for Metabolic and Bariatric Surgery
    Optimal Resources for Metabolic and Bariatric Surgery 2019 Standards facs.org/mbsaqip AMERICAN COLLEGE OF SURGEONS AMERICAN COLLEGE OF SURGEONS AMERICAN COLLEGE OF SURGEONS AMERICAN COLLEGE OF SURGEONS AMERICAN COLLEGE OF SURGEONS AMERICAN COLLEGE OF SURGEONS AMERICAN COLLEGE OF SURGEONS A AMERICAN COLLEGE OF SURGEONS Optimal Resources for Metabolic and Bariatric Surgery 2019 Standards Copyright © 2019 American College of Surgeons, 633 N. Saint Clair St., Chicago, IL 60611-3295. All rights reserved. Table Foreword ii MBSAQIP Designations and Accreditation Pathways vi of Contents Designations vii Designation Requirements Overview viii Accreditation Pathways x Standard 1 Institutional Administrative Commitment 1 1.1 Administrative Commitment 3 Standard 2 Program Scope and Governance 5 2.1 Volume Criteria 7 2.2 Low Acuity Center Patient and Procedure 9 Selection 2.3 Ambulatory Surgery Center Patient and 10 Procedure Selection 2.4 Metabolic and Bariatric Surgery (MBS) Committee 11 2.5 Metabolic and Bariatric Surgery (MBS) Director 13 2.6 Metabolic and Bariatric Surgery (MBS) 15 Coordinator 2.7 Metabolic and Bariatric Surgery (MBS) Clinical 16 Reviewer 2.8 Obesity Medicine Director (OMD) 18 Standard 3 Facilities and Equipment Resources 21 3.1 Health Care Facility Accreditation 23 3.2 Facilities, Equipment, and Furniture 24 3.3 Designated Bariatric Unit 26 Standard 4 Standard 6 Personnel and Services Resources 29 Data Surveillance and Systems 59 4.1 Credentialing Guidelines for Metabolic and 31 6.1 Data Entry 61 Bariatric Surgeons 6.2 30-Day
    [Show full text]
  • The Microbial Hypothesis: Contributions of Adenovirus Infection and Metabolic Endotoxaemia to the Pathogenesis of Obesity
    Hindawi Publishing Corporation International Journal of Chronic Diseases Volume 2016, Article ID 7030795, 11 pages http://dx.doi.org/10.1155/2016/7030795 Review Article The Microbial Hypothesis: Contributions of Adenovirus Infection and Metabolic Endotoxaemia to the Pathogenesis of Obesity Amos Tambo, Mohsin H. K. Roshan, and Nikolai P. Pace Centre for Molecular Medicine and Biobanking, University of Malta, Msida, Malta Correspondence should be addressed to Amos Tambo; [email protected] Received 24 July 2016; Revised 10 October 2016; Accepted 25 October 2016 Academic Editor: Jochen G. Schneider Copyright © 2016 Amos Tambo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The global obesity epidemic, dubbed “globesity” by the World Health Organisation, is a pressing public health issue. The aetiology of obesity is multifactorial incorporating both genetic and environmental factors. Recently, epidemiological studies have observed an association between microbes and obesity. Obesity-promoting microbiome and resultant gut barrier disintegration have been implicated as key factors facilitating metabolic endotoxaemia. This is an influx of bacterial endotoxins into the systemic circulation, believed to underpin obesity pathogenesis. Adipocyte dysfunction and subsequent adipokine secretion characterised by low grade inflammation, were conventionally attributed to persistent hyperlipidaemia. They were thought of as pivotal in perpetuating obesity. It is now debated whether infection and endotoxaemia are also implicated in initiating and perpetuating low grade inflammation. The fact that obesity has a prevalence of over 600 million and serves as a risk factor for chronic diseases including cardiovascular disease and type 2 diabetes mellitus is testament to the importance of exploring the role of microbes in obesity pathobiology.
    [Show full text]
  • Gynoid Vs Android Fat Distribution
    Gynoid vs android fat distribution Continue 20-09-2019Biology around the spread of android/ionoid On the DEXA scan you will see that it calculates the ratio of android gyoid. Android is described as the distribution of fat around the middle of the section, so around the waist (navel). Ginoid is the distribution of fat around the thighs, this region is located around the upper thighs. Where you store fat can help determine what type of shape you are and if you are more at risk of increasing visceral fat. If you store more fat around the android area (waist) it is considered the shape of an apple. Android/ginoid ratio of more than 1 will determine this, and you may be at greater risk of having high visceral fat (fat around the organs). If your A/G ratio is smaller than 1 you can see more fat stored around your hips. As a rule, ≤0.8, and males - 1. When a man's body fat % falls on some of the lower ranges it is common for the last bit of fat to be stored around the ginoid area. This ratio can be tracked over time to see if the fat is predominantly lost near one area or both. Where you store/distribute fat can also be transmitted through genetics, so it can be difficult to detect train certain areas. Biology! Android fat cells are predominantly visceral, they are large fat cells deposited under the skin and very metabolically active. The hormones they secrete have direct access to the liver, you may have heard of the term fatty liver.
    [Show full text]
  • Overnutrition, Ectopic Lipid and the Metabolic Syndrome Scott M Grundy
    Review Overnutrition, ectopic lipid and the metabolic syndrome Scott M Grundy Correspondence to ABSTRACT metabolic processes and predisposes to meta- Dr Scott M Grundy, Internal The metabolic syndrome is a constellation of bolic risk factors.6 Excess lipid in adipose tissue Medicine, UT Southwestsern Medical Center, Dallas, TX metabolic risk factors including atherogenic is called obesity; in other tissues, it is called 75390-9052, USA; scott. dyslipidemia (elevated serum triglycerides, reduced ectopic lipid. In this document, overnutrition [email protected] high-density lipoprotein (HDL) cholesterol), elevated will be defined as the any excess of nutrient blood pressure, dysglycemia (insulin resistance and energy that causes ectopic lipid accumulation Accepted 29 April 2016 elevated serum glucose), a pro-inflammatory state, outside adipose tissue. The essential pathways Published Online First 18 May 2016 and a prothrombotic state. Most persons with whereby overnutrition drives development of metabolic syndrome are obese, and usually have ectopic lipid are shown in figure 1. Excess Copyright © 2016 American fl Federation for Medical abdominal obesity. Generally, obesity is a re ection nutrients come from either dietary triglyceride Research of overnutrition. A current view is that when adipose or carbohydrate. Dietary triglyceride enters the tissue fails to store all excess nutrients as circulation with chylomicrons. Triglycerides are triglyceride, lipid begins to accumulate in various hydrolyzed to fatty acids by lipoprotein lipase tissues (eg, muscle, liver, pancreas, and heart). (LPL); and most of released fatty acids enter This accumulation is called ectopic lipid. Various adipose tissue, where they are re-esterified to mechanisms have been proposed whereby ectopic triglyceride. A portion of fatty acids released by lipid is detrimental in different tissues; these LPL bypasses adipose tissue and enters a variety derangements induce metabolic risk factors.
    [Show full text]
  • Obesity Medicine and Bariatric Surgery
    Obesity Medicine Your MOVE TIME Bariatric TEAM! • Obesity Medicine Physicians • Bariatric Surgeons • Behavioral Medicine/Psychologists • Dietitians • Physical Therapists • Nursing and Clerical staff Goals of the MOVE TIME Clinic • To help you lose weight, live a healthy lifestyle and improve your quality of life – Medical management to help those not interested in surgery or not surgical candidate – Medically optimize obesity-related comorbid conditions – Surgical management for those interested in weight-loss surgery Medical Evaluation: What do we do? • Evaluate causes of obesity • Evaluate/treat obesity-related conditions • Offer medical treatments for obesity – Weight loss medications • Pre-operative evaluation • Post-operative care Common Causes of Obesity • Inactivity- computer, gaming, TV time, commuting, desk work • Excess caloric intake- large portions, liquid calories (alcohol/sodas), unhealthy food choices Medical Causes of Obesity • Untreated Sleep Apnea (OSA) • Insomnia/Poor sleep • Hormone related- Hypothyroidism, Polycystic Ovarian Syndrome, Low Testosterone, Cushings • Depression, anxiety, PTSD, sexual trauma, stress • Medications- e.g. psychiatric medications, insulin for diabetes • Genetics/Epigenetics • Traumatic Brain Injuries Medical conditions related to Obesity • Diabetes • Heart Failure • High Blood Pressure • Kidney disease • High Cholesterol • Inflammation • Sleep Apnea • Blood Clots • Heart Burn/Reflux • Cancers • Joint • Infertility pain/Osteoarthritis • Urinary Incontinence • Fatty liver and cirrhosis • Hormone
    [Show full text]
  • Nutritional Strategy for Adolescents Undergoing Bariatric Surgery: Report of a Working Group of the Nutrition Committee of NASPGHAN/NACHRI
    CLINICAL GUIDELINE Nutritional Strategy for Adolescents Undergoing Bariatric Surgery: Report of a Working Group of the Nutrition Committee of NASPGHAN/NACHRI ÃMichell A. Fullmer, yStephanie H. Abrams, zKathleen Hrovat, §Lori Mooney, jjAnn O. Scheimann, zJennifer B. Hillman, and ôDavid L. Suskind ABSTRACT besity seen during adolescence is a multifactorial process Surgical options for the treatment of adolescent obesity have been gaining with several contributing factors, including metabolic dys- popularity. Adolescent patients present a particular challenge to clinicians, O secondary to age-related issues, revolving around both mental and physical regulation, genes, environmental/socioeconomic stressors, and growth. These age-related issues require a unique approach to nutritional energy imbalance (1). Patients with obesity carry an increased intervention for adolescents undergoing bariatric surgery as opposed to morbidity and are at risk for obstructive sleep apnea, metabolic standardized approaches for adults. Despite the increasing numbers of syndrome, orthopedic issues, hypertension, type 2 diabetes, and adolescents undergoing obesity surgery, evidence-based nutritional guide- nonalcoholic steatohepatitis (1,2). These comorbid conditions lines have yet to be published. The goal of this document is to provide the affect an adolescent’s quality of life and daily functioning (3). clinician with recommendations on how to assess, educate, nourish, and The obesity rates of children ages 2 to 19 are now 17.6%, with monitor the adolescent who has undergone obesity surgery. A multidisci- plinary panel composed of 3 pediatric gastroenterologists, 1 psychologist, obesity being classified as a body mass index (BMI) above the 95th and 3 registered dietitians from the Nutrition Committee for the North percentile (4).
    [Show full text]
  • H1-Antihistamines for Chronic Spontaneous Urticaria: an Abridged Cochrane Systematic Review
    H1-antihistamines for chronic spontaneous urticaria: An abridged Cochrane Systematic Review Sharma, Maulina , Bennett, C. , Carter, Ben and Cohen, Stuart N. Author post-print (accepted) deposited by Coventry University’s Repository Original citation & hyperlink: Sharma, Maulina , Bennett, C. , Carter, Ben and Cohen, Stuart N. (2015) H1-antihistamines for chronic spontaneous urticaria: An abridged Cochrane Systematic Review . Journal of the American Academy of Dermatology, volume 73 (4): 710-716 http://dx.doi.org/10.1016/j.jaad.2015.06.048 DOI 10.1016/j.jaad.2015.06.048 ISSN 0190-9622 ESSN 1097-6787 Publisher: Elsevier NOTICE: this is the author’s version of a work that was accepted for publication in Journal of the American Academy of Dermatology. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of the American Academy of Dermatology, [VOL 73, ISSUE 4, (2015)] DOI: 10.1016/j.jaad.2015.06.048 © 2015, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial- NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ Copyright © and Moral Rights are retained by the author(s) and/ or other copyright owners. A copy can be downloaded for personal non-commercial research or study, without prior permission or charge. This item cannot be reproduced or quoted extensively from without first obtaining permission in writing from the copyright holder(s). The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the copyright holders.
    [Show full text]
  • Tor Amendment Tagoor Laboratories Private Limited
    ToR Amendment Tagoor Laboratories Private Limited ANNEXURE – I Details of Products as per Granted ToR and Amendment Required Production Capacity S. Ton /Month Therapeutic Product Name No As per Amendment category granted ToR Required 1 Abacavir sulfate 2.0 2.0 Anti HIV 2 Amitriptyline 5.0 10.0 Antidepressant 3 Atrovastatin Calcium 5.0 5.0 Hypercholesterolemia 4 Bupropion 5.0 5.0 Anti depressant 5 carisoprodol 2.0 2.0 Muscle Relaxant 6 Clopidogrelbisulfate 5.0 5.0 Antithrombotic 7 Cyclobenzaprine HCl 5.0 5.0 Muscle relaxant 8 Cyproheptadine HCl 5.0 10.0 Anti allergic 9 Desloratadine 5.0 5.0 Antihistamine 10 Domperidone 20.0 30.0 Anti emetic 11 Domperidone maleate 2.0 2.0 Anti emetic 12 Donepezil HCl 1.0 1.0 Alzheimer’s disease 13 Ebastine 5.0 5.0 Anti allergic 14 Esomeprazole Sodium 3.0 3.0 Anti ulcerative Esomeprazole Magnesium 3.0 3.0 Anti ulcerative 15 trihydrate 16 Fexofenadine Hydrochloride 6.0 15.0 Anti histamine 17 Haloperidol 2.0 2.0 Antipsychotic 18 Itopride Hydrochloride 2.0 2.0 Antispasmodics 19 Itraconazole 10.0 10.0 Antifungal 20 Ketrolac Tromethane 2.0 2.0 Anti Inflammatory 21 Lansoprazole 10.0 10.0 Ant ulcerative 22 Loperamide Hydrochloride 10.0 10.0 Anti diarrhea agent 23 Losartan Potassium 6.0 15.0 Anti Hypertensive 24 Nebivolol HCl 2.0 2.0 Anti Hypertensive 25 Nortriptyline HCl 2.0 2.0 Anti depressant 26 Omeprazole 40.0 40.0 Anti ulcerative 27 Omeprazole Sodium 2.0 2.0 Ant ulcerative Omeprazole Magnesium 2.0 2.0 Ant ulcerative 28 Dihydrate 29 Oxatomide 1.0 1.0 Antihistamine Pantoprazole Sodium Sesqui 10.0 20.0 Ant ulcerative 30 Hydrate 31 Pimozide 2.0 2.0 Antipsychotic 32 Pregabalin 2.0 2.0 Epileptic 33 Quetiapine Hemifumarate 2.0 2.0 Antipsychotic Prepared By Rightsource Industrial Solutions Pvt.
    [Show full text]
  • Body Fat Distribution As a Risk Factor for Osteoporosis
    SAMJ I ARTICLES In the past, most epidemiological studies that examined Body fat distribution as a the association between obesity and disease considered only total adipose tissue and ignored its distribution. risk factor for osteoporosis Recently it has become apparent that it is not obesity per se, but the regional distribution of adipose tissue, that Renee Blaauw, Eisa C. Albertse, Stephen Hough correlates with many obesity-related morbidities including atherosclerosis, hypertension, hyperlipidaemias and 4 diabetes mellitus. -8 Objective. The aim of this study was to compare the body The anatomical distribution of adipose tissue differs fat distribution of patients with osteoporosis (GP) with that between men and women in both normal and obese of an appropriately matched non-GP control group. individuals, suggesting that sex hormones are involved in Design. Case control study. the regulation of adipose tissue metabolism.5--10 Upper body Setting. Department of Endocrinology and Metabolism, (android or waist) obesity, which is typically observed in men, is associated with hyperandrogenism, whereas lower Tygerberg Hospital. body (gynoid or hip) obesity is far more common in women, Participants. A total of 56 patients with histologicatly suggesting an oestrogenic influence.':>-12 Moreover, upper proven idiopathic GP, of whom 39 were women (mean age body obesity has been shown to be associated with 61 ± 11 years) and 17 men (49 ± 15 years), were compared hypercortisolism and classically occurs in patients with with 125 age- and sex-matched non-OP (confirmed by Cushing's syndrome. 13 Since hypogonadism and dual energy X-ray absorptiometry) subjects, 98 women hypercortisolaemia are well-known causes of GP, we questioned whether this disease was also associated with (60 ± 11 years) and 27 men (51 ± 16 years).
    [Show full text]