Bariatric and Metabolic Surgery in Adolescents: a Path to Decrease Adult Cardiovascular Mortality
Abstract Obesity is a major health problem across all age groups and has escalated to pandemic proportions. The proportion of children with overweight or obesity has risen rapidly over recent decades, and it is recognized that most obese children become obese adults. Furthermore, BMI is the strongest CV risk factor to track from childhood into adulthood. As well as BMI, multiple CV risk factors begin in childhood and strong associations between these factors and BMI are evident. Clear evidence exists for the CV benefits of reversing obesity in adults, much of which examines the effects of bariatric surgery. The capacity of bariatric surgery to reliably achieve safe and lasting improvement in BMI is unparalleled, and the emerging evidence base in adolescent bariatric surgery has so far concurred. In the absence of effective alternatives, it appears that the increase in use of bariatric surgery in adolescents will continue.
Abstract Obesity is a global pandemic associated with macro- and microvascular endothelial dysfunction. Microvascular endothelial dysfunction has recently emerged as a significant risk factor for the development of cognitive impairment. In this review, we present evidence from clinical and preclinical studies supporting a role for obesity in cognitive impairment. Next, we discuss how obesity-related hyperinsulinemia/insulin resistance, systemic inflammation, and gut dysbiosis lead to cognitive impairment through induction of endothelial dysfunction and disruption of the blood brain barrier. Finally, we outline the...
This study is the first to use a uniform ‘U’ stitch pattern across all centers to simplify technical aspects of the procedure and limit cost.
Diabetes has reached pandemic magnitude globally. Over the last 20 years, there has been increasing evidence that bariatric surgery can elicit potent effects to improve the metabolic state in obese subjects with T2D. However, bariatric surgery is associated with a background rate of severe adverse events that renders this intervention unappealing for many patients. Approximately, 4% severe adverse events and up to 3% mortality rate have been reported. Therefore, novel minimally invasive procedures are under development that can elicit some of the benefits of bariatric surgery but with a more favorable safety and tolerability profile.
Obesity is a worldwide pandemic and bariatric surgery is the most effective treatment modality. Despite its satisfactory clinical results, some patients regain part of their lost weight. Traditionally, revisional surgery to reduce the gastrojejunal anastomosis (GJA) is offered to these patients. However, revisional procedures carry a higher complication rate than primary bariatric surgeries including fistulas and dehiscence with incidences ranging from 1 to 8.3% after laparoscopic RYGB. The diagnosis and treatment of bariatric surgery leaks are challenging due to nonspecific clinical and laboratory findings.
The global pandemic of obesity has a gigantic social and financial impact, and alternatives for the treatment and control of this pathology are imperative. Morbid obese Patients are treated very efficiently by the various Bariatric surgery techniques, while overweight patients have good results with drug interventions and changes in lifestyle. For the patients who are at the intersection of these two strategies, the endoscopic treatment of obesity with the intragastric balloon is a very interesting and widely used alternative.
Obesity has become a global pandemic, and the complex physical, social, and psychological dimensions of the disease affect all ages and socioeconomic groups. Endoscopic sleeve gastroplasty (ESG) is a minimally invasive endoscopic bariatric therapy with demonstrated efficacy and durability for weight loss and obesity-related comorbidities and is in many cases an alternative to laparoscopic or open surgical approaches.
Katherine Samaras1,2,3*, Henrik Tevaerai4, Michel Goldman5, Johannes le Coutre6,7 and Jeff M. P. Holly8 1Department of Endocrinology, St Vincent's Hospital, Darlinghurst, NSW, Australia 2Diabetes and Metabolism, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia 3St Vincent's Hospital, St Vincent's Clinical School, Darlinghurst, NSW, Australia 4Bern University Hospital, Bern, Switzerland 5Institute for Interdisciplinary Innovation in Healthcare, Universite Libre de Bruxelles, Bruxelles, Belgium 6Department of Medicine, Imperial College London, London, United Kingdom 7Nes...
Conclusions: Bariatric surgery appears to be capable of partially reversing the obesity-related epigenome. The identification of potential epigenetic biomarkers predictive for the success of bariatric surgery may open new doors to personalized therapy for severe obesity. Introduction Obesity is currently a huge healthcare problem, worldwide, and is a risk factor for several diseases such as type 2 diabetes (T2D), cardiovascular disease and cancer (1). As the prevalence of obesity reaches pandemic proportions, this metabolic disease is estimated to become the biggest cause of mortality in the near future (2). In fact,...
ConclusionsDJBS endoscopic removal is safe and effective even in challenging cases, thus preventing the need for surgical intervention.
Epidemiological trends and recent literature reports indicate that the combination of bariatric surgery as a first step followed by orthopedic interventions as a second stage is beneficial for our patients. Bariatric interventions have proven to be safe and efficacious, offering a bridge to patients affected by severe obesity and osteoarthritis (OA) to undergoing a successful and long-lasting joint replacement. In addition, the combination of joint replacement after bariatric interventions will help patients resume their normal activities while introducing lifestyle changes that will, in turn, enable them to maintain weight loss.