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As the worldwide prevalence of morbid obesity among adolescents
continues to rise, recent years have seen a large increase in the
performance of adolescent bariatric surgery. While surgical
intervention often becomes necessary when conservative weight-loss
therapies have failed, no standards regarding the post-operative
regimen and long-term management of adolescent patients have been
established. Thus, the treatment of obesity and its co-morbidities
requires a multidisciplinary approach, taking into account
epidemiological, clinical, nutritional and genetic aspects of
morbid obesity in the pediatric age group. This volume discusses
both conventional therapy and surgical options for morbid obesity
in the pediatric age group. In the first part, obesity-related
diseases, genetics and psychological factors are analyzed. The
second part focuses on current bariatric surgery procedures,
including dietary restrictions and guidelines to prevent
nutritional deficiencies common after surgery. Therefore, the book
will prove an invaluable resource for pediatricians, surgeons,
nutritionists, dieticians and all other health professionals who
treat adolescent obesity.
There is increasing evidence for the clinicial value of the apo
lipoprotein measurements. Besides cholesterol in plasma and li
poprotein fractions, which is currently used as an indicator of
cardiovascular risk, the measurement of the AI and B apolipopro
teins can provide additional information about the patients'
clinical status. Several studies show that apo B is higher and apo
AI is lower in patients with angiographically documented coronary
heart dis ease than in symptomatic patients without coronary heart
disease. Moreover, discriminant analysis indicated that the
concentration of Apo AI and B in plasma are better discriminators
than lipo protein cholesterol for identifying patients with
coronary heart disease. In some studies the apo Bjapo AI ratio
appears to be a more powerful predictor than individual
lipoproteins. In a recent study carried out in men, apolipoproteins
AI and B were better correlated with the severity of cardiovascular
disease than HDL and LDL cholesterol. The predictive power of
apolipoproteins could however not be demonstrated in all studies
and the value of apolipoprotein measurements in the field of
clinical chemistry is still controversial. This is probably due to
discrepancies between the results of various studies, arising from
differences in the type of immunoassays, the lack of universal
reference materials, differ ences between study protocols,
variations in the selection of patients and in the grading and
interpretation of coronary lesions."
As the worldwide prevalence of morbid obesity among adolescents
continues to rise, recent years have seen a large increase in the
performance of adolescent bariatric surgery. While surgical
intervention often becomes necessary when conservative weight-loss
therapies have failed, no standards regarding the post-operative
regimen and long-term management of adolescent patients have been
established. Thus, the treatment of obesity and its co-morbidities
requires a multidisciplinary approach, taking into account
epidemiological, clinical, nutritional, and genetic aspects of
morbid obesity in the pediatric age group. This volume discusses
both conventional therapy and surgical options for morbid obesity
in the pediatric age group. In the first part, obesity-related
diseases, genetics, and psychological factors are analyzed. The
second part focuses on current bariatric surgery procedures,
including dietary restrictions and guidelines to prevent
nutritional deficiencies common after surgery. Therefore, the book
will prove an invaluable resource for pediatricians, surgeons,
nutritionists, dieticians, and all other health professionals who
treat adolescent obesity.
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