scholarly journals Use of Lisdexamfetamine to Treat Obesity in an Adolescent with Severe Obesity and Binge Eating

Children ◽  
2019 ◽  
Vol 6 (2) ◽  
pp. 22 ◽  
Author(s):  
Gitanjali Srivastava ◽  
Valerie O’Hara ◽  
Nancy Browne
Keyword(s):  
Weight Management ◽  
Pediatric Obesity ◽  
Severe Obesity ◽  
Clinical Care ◽  
Care Center ◽  
Tertiary Care ◽  
Healthy Weight ◽  
Care Needs ◽  
Therapeutic Modalities ◽  
Pediatric Weight Management

Approximately two-thirds of US children and adolescents have either obesity or overweight status, with almost 24% of adolescents (ages 12–19 years) afflicted with severe obesity, defined as >1.2 × the 95th BMI percentile for age/gender. Despite the increasing disproportionate rise in severe or extreme childhood obesity, many children in weight management programs do not achieve a healthy weight. Most often, these patients will go on to require metabolic and bariatric surgery (MBS), but challenges and limitations may prohibit MBS on adolescents. Thus, tertiary care pediatric weight management centers are compelled to treat select pediatric obesity subtypes presenting with disease progression and disability with the available adult FDA-approved therapeutic modalities, specifically pharmacotherapy, in order to alleviate the disease state and provide relief to the patient. Here, we describe a case of severe pediatric obesity where a dedicated multidisciplinary pediatric weight management team at a tertiary care center utilizes a progressive pharmacotherapeutic approach with enormous benefits to the patient, highlighting the urgent gap and clinical care needs of this special population niche of severe adolescent obesity.

Planned Evaluation of the Healthy Weight Clinic Pediatric Weight Management and Implementation: Massachusetts-CORD 3.0

2021 ◽  
Vol 17 (S1) ◽  
pp. S-55-S-61
Author(s):  
Lauren Fiechtner ◽  
Desiree Sierra Velez ◽  
Sujata G. Ayala ◽  
Ines Castro ◽  
Jeanne Lindros ◽  
...  
Keyword(s):  
Weight Management ◽  
Healthy Weight ◽  
Pediatric Weight Management

scholarly journals Inpatient and Emergency Room Ophthalmology Consultations at a Tertiary Care Center

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Daniel J. Oh ◽  
Levi N. Kanu ◽  
Judy L. Chen ◽  
Ahmad A. Aref ◽  
William F. Mieler ◽  
...  
Keyword(s):  
Emergency Room ◽  
Clinical Care ◽  
Care Center ◽  
Tertiary Care ◽  
Significant Proportion ◽  
Field Evaluation ◽  
Consulting Services ◽  
Wide Range ◽  
A Prospective Study ◽  
The University

Background. An ophthalmology consultation service is of significant benefit to patients in the hospital and is an instructive component of a residency education program. Ophthalmology consultations in a hospital present unique challenges to those seen in an outpatient clinic, for which the consulting ophthalmologist should be prepared. The purpose of this study was to profile the emergency room and inpatient ophthalmology consultations seen at an academic institution. Methods. A prospective study of 581 patients was conducted on inpatient and emergency room ophthalmology consultations at the University of Illinois at Chicago over twelve months. Characteristics such as the consulting service, type of and reason for consultation, subspecialty staffing service, diagnosis, and suitability for in-hospital evaluation were recorded. Results. Consultations were received from either inpatient wards (59.4%) or the Emergency Department (40.6%). The most common inpatient consulting services were internal medicine (22%), followed by neurosurgery (16%) and neurology (7%). All the consultations were categorized as acute (72.3%), chronic (6.0%), or screening (21.7%). Consultations categorized as screening included papilledema (31.0%), fungemia (20.6%), syndromic evaluation (19.8%), visual field evaluation (17.5%), and miscellaneous evaluation (11.1%). We classified the ophthalmic diagnoses into 63 unique diagnoses. Amongst the ophthalmic subspecialties, neuro-ophthalmologic diagnoses were the most common (32.0%), followed by retina (20.1%) and cornea (19.4%). Neuro-ophthalmology had the highest proportion of screening consultations (36.6%), while glaucoma had the least overall number of consultations (10.1%), and the least proportion of screening consultations (3.6%). A significant proportion of nonacute consultations (19.0%) was deemed to be more suitable for outpatient evaluation. Discussion. Consultation databases can be useful in preparing trainees for in-hospital clinical care. A wide range of ocular pathologies may present to the ophthalmology consultant, from acute trauma to screening for systemic syndromes. Some consultations may be more suitable for outpatient evaluation which may help optimize patient care.

scholarly journals Hospitalized COVID-19 Patients treated with Convalescent Plasma in a Mid-size City in the Midwest

2020 ◽  
Author(s):  
William Hartman ◽  
Aaron S Hess ◽  
Joseph P Connor
Keyword(s):  
Mechanical Ventilation ◽  
Care Center ◽  
Severe Disease ◽  
Tertiary Care ◽  
The United States ◽  
Severe Illness ◽  
Care Needs ◽  
Course Of Disease ◽  
Effective Option ◽  
Life Threatening

AbstractBackgroundSARS-CoV-2 and its associated disease, COVID-19, has infected over seven million people world-wide, including two million people in the United States. While many people recover from the virus uneventfully, a subset of patients will require hospital admission, some with intensive care needs including intubation, and mechanical ventilation. To date there is no cure and no vaccine is available. Passive immunotherapy by the transfusion of convalescent plasma donated by COVID-19 recovered patients might be an effective option to combat the virus, especially if used early in the course of disease. Here we report our experience of using convalescent plasma at a tertiary care center in a mid-size, midwestern city that did not experience an overwhelming patient surge.MethodsHospitalized COVID-19 patients categorized as having Severe or Life-Threatening disease according to the Mayo Clinic Emergency Access Protocol were screened, consented, and treated with convalescent plasma collected from local donors recovered from COVID-19 infection. Clinical data and outcomes were collected retrospectively.Results31 patients were treated, 16 severe patients and 15 life-threatened patients. Overall mortality was 27% (4/31) but only patients with life-threatening disease died. 94% of transfused patients with severe disease avoided escalation to ICU care and mechanical ventilation. 67% of patients with life-threatening disease were able to be extubated. Most transfused patients had a rapid decrease in their respiratory support requirements on or about day 7 following convalescent plasma transfusion.ConclusionOur results demonstrate that convalescent plasma is associated with reducing ventilatory requirements in patients with both severe and life-threatening disease, but appears to be most beneficial when administered early in the course of disease when patients meet the criteria for severe illness.

Experiences of Canadian Parents of Young Children With Cleft Lip and/or Palate

2020 ◽  
pp. 105566562097727
Author(s):  
Eleonore E. Breuning ◽  
Rebecca J. Courtemanche ◽  
Douglas J. Courtemanche
Keyword(s):  
Health Care ◽  
Young Children ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Care Center ◽  
Tertiary Care ◽  
Support Network ◽  
Tertiary Care Center ◽  
Care Needs ◽  
Care Experience

Purpose: Prior literature has described the perspectives of parents of young children with clip lip and/or palate; however, few studies have described parents’ experiences within a Canadian health care system. This study aims to better understand the experiences of parents of young children with cleft lip and/or palate seen at a Canadian tertiary care center and identify their care needs. Design: In-depth semistructured interviews. Setting: Pediatric tertiary care center. Participants: Parents of children younger than 7 years of age with cleft lip and/or palate. Results: From 14 interviews, 4 themes were identified. The diagnosis theme was associated with reactions, timing, and search for information. Key concerns within the theme of physiology and function were around feeding and speech. The health care experience theme included burden of care, peripheral hospitals and services, the cleft lip and palate clinic, and clinicians. The psychosocial theme included parents’ reactions to their child’s pain, coping strategies, family interactions, and school/day care experiences. Parents felt care could be improved by having: access to good information and community speech therapists, shorter appointment wait times, a peer support network, and increased cleft knowledge within their child’s school and peer groups. Conclusions: The experience of parents of children with cleft lip and/or palate is complex but can be organized into 4 themes. Clinics may consider suggestions offered by parents to improve care. Future work should address parents’ needs and aim to create a parent-reported quality-of-life measure specific to parents of young children with cleft lip and/or palate.

Parent Recommendations to Enhance Enrollment in Multidisciplinary Clinical Care for Pediatric Weight Management

2018 ◽  
Vol 192 ◽  
pp. 122-129 ◽  
Author(s):  
Arnaldo J. Perez ◽  
Maryam Kebbe ◽  
Nicholas L. Holt ◽  
Rebecca Gokiert ◽  
Jean-Pierre Chanoine ◽  
...  
Keyword(s):  
Weight Management ◽  
Clinical Care ◽  
Pediatric Weight Management

scholarly journals Hospitalized COVID-19 patients treated with convalescent plasma in a mid-size city in the Midwest

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
William R. Hartman ◽  
Aaron S. Hess ◽  
Joseph P. Connor
Keyword(s):  
Mechanical Ventilation ◽  
Care Center ◽  
Severe Disease ◽  
Tertiary Care ◽  
The United States ◽  
Severe Illness ◽  
Care Needs ◽  
Course Of Disease ◽  
Effective Option ◽  
Life Threatening

Abstract Background SARS-CoV-2 and its associated disease, COVID-19, has infected over seven million people world-wide, including two million people in the United States. While many people recover from the virus uneventfully, a subset of patients will require hospital admission, some with intensive care needs including intubation, and mechanical ventilation. To date there is no cure and no vaccine is available. Passive immunotherapy by the transfusion of convalescent plasma donated by COVID-19 recovered patients might be an effective option to combat the virus, especially if used early in the course of disease. Here we report our experience of using convalescent plasma at a tertiary care center in a mid-size, midwestern city that did not experience an overwhelming patient surge. Methods Hospitalized COVID-19 patients categorized as having Severe or Life-Threatening disease according to the Mayo Clinic Emergency Access Protocol were screened, consented, and treated with convalescent plasma collected from local donors recovered from COVID-19 infection. Clinical data and outcomes were collected retrospectively. Results 31 patients were treated, 16 severe patients and 15 life-threatened patients. Overall mortality was 27% (4/31) but only patients with life-threatening disease died. 94% of transfused patients with severe disease avoided escalation to ICU care and mechanical ventilation. 67% of patients with life-threatening disease were able to be extubated. Most transfused patients had a rapid decrease in their respiratory support requirements on or about day 7 following convalescent plasma transfusion. Conclusion Our results demonstrate that convalescent plasma is associated with reducing ventilatory requirements in patients with both severe and life-threatening disease, but appears to be most beneficial when administered early in the course of disease when patients meet the criteria for severe illness.

scholarly journals The Impact of Pet Care Needs on Medical Decision-Making among Hospitalized Patients: A Cross-Sectional Analysis of Patient Experience

2021 ◽  
Vol 8 ◽  
pp. 237437352110460
Author(s):  
Carri S. Polick ◽  
Jennifer W. Applebaum ◽  
Caitlin Hanna ◽  
Darnysus Jackson ◽  
Sophia Tsaras-Schumacher ◽  
...  
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Negative Impact ◽  
Care Center ◽  
Tertiary Care ◽  
Hospitalized Patients ◽  
Medical Decision ◽  
Care Needs ◽  
Cross Sectional ◽  
The Impact

Hospital-based protocols to support pet care needs for hospitalized patients may have potential to benefit patient health and wellbeing, but must be informed by experiences of hospitalized pet owners. The aim of this study was to determine the scope and need for pet care services among hospitalized patients. A panel of prior inpatients and their family members at a tertiary care center were surveyed about preferences, experiences, and need for assistance with pet care during hospitalization. Respondents (n = 113) expressed interest in a low/no-cost pet-boarding or foster program for adult patients struggling to find pet care assistance. The majority of respondents (n = 71; 63%) reported challenges securing pet care during a prior hospitalization, and/or knew someone who encountered similar challenges. Respondents also indicated that these challenges had a negative impact on health, recovery, or their own decision to receive medical care. Pet care challenges during hospitalization are likely common and have the potential to hamper medical decision-making and health outcomes of inpatients.

Percutaneous Tracheostomy in Severe Obesity: Experience at a Tertiary Care Center

CHEST Journal ◽  
2013 ◽  
Vol 144 (4) ◽  
pp. 66A
Author(s):  
David Chambers ◽  
Rebecca Cloyes ◽  
Abdulgadir Adam ◽  
Shaheen Islam
Keyword(s):  
Severe Obesity ◽  
Care Center ◽  
Percutaneous Tracheostomy ◽  
Tertiary Care ◽  
Tertiary Care Center

scholarly journals Aversion to Off-Label Prescribing in Clinical Pediatric Weight Management: The Quintessential Double Standard

2021 ◽  
Author(s):  
Christine B San Giovanni ◽  
Brooke Sweeney ◽  
Joseph A Skelton ◽  
Megan M Kelsey ◽  
Aaron S Kelly
Keyword(s):  
Weight Management ◽  
Pediatric Obesity ◽  
Pediatric Patients ◽  
Lifestyle Modification ◽  
Treatment Options ◽  
Double Standard ◽  
Case Description ◽  
Off Label ◽  
Novel Treatments ◽  
Pediatric Weight Management

Abstract Context Pediatric obesity is now recognized as a chronic disease; yet few treatment options exist besides lifestyle modification therapy and bariatric surgery. We describe the limited availability of FDA-approved anti-obesity medications for adolescents and compare this to what is available for adults. We offer a rationale for off-label prescribing to assist with lifestyle modification therapy. We also highlight the need for more pharmacotherapy options and additional research into novel treatments for pediatric obesity. Case Description We describe a patient who is struggling with managing her weight and starting to develop complications of obesity. We offer a framework in which off-label prescribing may be beneficial to patients who have been engaging in lifestyle modification therapy yet fail to see improvement. Conclusion Lifestyle modification therapy is necessary but often insufficient in stimulating clinically meaningful weight loss when used alone in children and adolescents who struggle with weight management. Until more FDA-approved anti-obesity medications are available, pediatricians may be able to help more patients achieve weight reduction goals by familiarizing themselves with the responsible use of off-label medications and implementing these tools to improve clinical outcomes. There is a critical need for more pharmacotherapy options to help pediatric patients in managing their weight and preventing or improving the insidious complications resulting from untreated obesity.

Prevalence of comorbid conditions pre-existing and diagnosed at a tertiary care pediatric weight management clinic

2018 ◽  
Vol 31 (4) ◽  
pp. 385-390 ◽  
Author(s):  
Griselle Leon ◽  
Elizabeth de Klerk ◽  
Josephine Ho ◽  
Michelle Jackman ◽  
Raylene A. Reimer ◽  
...  
Keyword(s):  
Weight Management ◽  
Mental Health Problems ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Physical And Mental Health ◽  
Cross Sectional ◽  
Alcoholic Fatty Liver ◽  
Obstructive Sleep ◽  
Prevalence Of Obesity ◽  
Pediatric Weight Management

AbstractBackground:Childhood obesity places individuals at risk for a multitude of physical and mental health problems. The aim of this study was to assess the prevalence of obesity related comorbidities diagnosed prior to and after attending a tertiary care pediatric weight management clinic.Methods:A cross sectional retrospective chart review of patients 2–17 years old seen in the weight management clinic at Alberta Children’s Hospital from May 2012 to May 2014.Results:A total of 199 patients were included in the review. Comorbidity prevalences were: hypertension 6 (3%), prediabetes 11 (5.5%), type 2 diabetes 3 (1.5%), dyslipidemia 105 (52.8%), non-alcoholic fatty liver disease 31 (15.6%), asthma 45 (22.6%), obstructive sleep apnea 21 (10.6%), and polycystic ovarian syndrome (PCOS) 9 (12% of females ≥10 years at the first visit). Concerns related to depression and anxiety were present in 20 (10.1%) and 25 (12.6%) patients respectively. The majority of comorbidities were identified prior to joining the clinic. Conditions requiring more specialized tests, such as diabetes and PCOS, were more commonly identified after joining the clinic.Conclusions:These results give further insight into the prevalence of obesity-related comorbidities in overweight and obese children and adolescents, and demonstrate the importance of screening for these known comorbidities. It is important to have the resources and an experienced multi-disciplinary team to follow children and their families through treatment.

Sign in / Sign up

Export Citation Format

Share Document