The document discusses obesity in children, including:
1. Definitions of overweight and obesity based on BMI percentiles.
2. The prevalence of childhood obesity has increased worldwide and in the United States over the past few decades based on surveys.
3. The prevalence of childhood obesity varies significantly across different countries in the Arab world, with some of the highest rates in girls found in Kuwait, Oman, and Libya.
What are the causes and effects of childhood obesity, and what strategies can health and government bodies use to tackle the issue? Nathalie Farpour-Lambert, President of the European Association for the Study of Obesity (EASO), examines scientific data and presents recommendations. This presentation was delivered as part of a Global Active City and Ciudad Activa Summit in Buenos Aires in October 2018. EASO is a supporting partner of the Active Well-being Initiative, which runs the Global Active City programme. The world’s first Global Active Cities are Buenos Aires, Hamburg, Lillehammer, Liverpool, Ljubljana, and Richmond, British Columbia, Canada. Visit http://www.activewellbeing.org or follow @AWBInitiative on Twitter.
Management of SEVERE ACUTE MALNUTRITIONRAVI PRAKASH
MANAGEMENT OF SEVERE ACUTE MALNUTRITION :-
DEALT WITH INVESTIGATION AND TREATMENT OF CHILD SUFFERING FROM SEVERE ACUTE MALNUTRITION, ESSENTIAL AND LATEST GUIDELINES FOR MANAGEMENT
Management Guidelines of Severe Acute Malnutrition SAM in PediatricsBirhanu Melese
Children with severe acute malnutrition need to be treated with specialized therapeutic diets (F75 and F100 formula; RUTF) alongside the diagnosis and management of complications during in-patient care.
Managment of Diabesity (Obesity in diabetes mellitus) Tarek Al 3reeny
This presentation summaries state of the art management of obesity in diabetes mellitus (diabesity) including definition and classifications of both obesity and diabetes. Multidisciplinary approach , pharmacotherapy & bariatric surgery
The presentation has three parts: UNITE for Diabetes Philippines CPG recommendations on medical nutrition therapy (MNT), improving adherence to MNT and use of SMS.
What are the causes and effects of childhood obesity, and what strategies can health and government bodies use to tackle the issue? Nathalie Farpour-Lambert, President of the European Association for the Study of Obesity (EASO), examines scientific data and presents recommendations. This presentation was delivered as part of a Global Active City and Ciudad Activa Summit in Buenos Aires in October 2018. EASO is a supporting partner of the Active Well-being Initiative, which runs the Global Active City programme. The world’s first Global Active Cities are Buenos Aires, Hamburg, Lillehammer, Liverpool, Ljubljana, and Richmond, British Columbia, Canada. Visit http://www.activewellbeing.org or follow @AWBInitiative on Twitter.
Management of SEVERE ACUTE MALNUTRITIONRAVI PRAKASH
MANAGEMENT OF SEVERE ACUTE MALNUTRITION :-
DEALT WITH INVESTIGATION AND TREATMENT OF CHILD SUFFERING FROM SEVERE ACUTE MALNUTRITION, ESSENTIAL AND LATEST GUIDELINES FOR MANAGEMENT
Management Guidelines of Severe Acute Malnutrition SAM in PediatricsBirhanu Melese
Children with severe acute malnutrition need to be treated with specialized therapeutic diets (F75 and F100 formula; RUTF) alongside the diagnosis and management of complications during in-patient care.
Managment of Diabesity (Obesity in diabetes mellitus) Tarek Al 3reeny
This presentation summaries state of the art management of obesity in diabetes mellitus (diabesity) including definition and classifications of both obesity and diabetes. Multidisciplinary approach , pharmacotherapy & bariatric surgery
The presentation has three parts: UNITE for Diabetes Philippines CPG recommendations on medical nutrition therapy (MNT), improving adherence to MNT and use of SMS.
These slides present key data and information on child obesity and excess weight. They have been produced by the Obesity Risk Factors Intelligence team at PHE and can be used freely with acknowledgement to ‘Public Health England’.
These slides should be useful to practitioners and policy makers working to tackle child obesity at local, regional and national level. For example they are regularly used to make the case for tackling obesity in presentations to health and wellbeing boards, other committees and to elected members as well as in regional and national conference and workshop presentations.
As part of the IFPRI Egypt Seminar in partnership with the FAO: “Food Policies and their Implications on Overweight and Obesity Trends in Selected Countries in MENA Region”
These PowerPoint slides present key data and information on adult obesity in clear, easy to understand charts and graphics. They have been produced by the Obesity Risk Factors Intelligence team in the Health Improvement Directorate and can be used freely with acknowledgement to ‘Public Health England’.
These slides should be useful to practitioners and policy makers working to tackle adult obesity at local, regional and national level. For example they are regularly used to make the case for tackling obesity in presentations to health and wellbeing boards, other committees and to elected members as well as in regional and national conference and workshop presentations.
29 November Launch of the Global Nutrition Report 2018
The 2018 Global Nutrition Report shares insights into the current state of global nutrition, highlighting the unacceptably high burden of malnutrition in the world. It identifies areas where progress has been made in recent years but argues that it is too slow and too inconsistent. It puts forward five critical steps that are needed to speed up progress to end malnutrition in all its forms and argues that, if we act now, it is not too late to achieve this goal. In fact, we have an unprecedented opportunity to do so.
This ground breaking program provided both survivors and health care professionals the opportunity to leverage each other's insights and an opportunity for all to hear "state-of-the-science" presentations on the epidemiology, pathogenesis, genomics and optimal multidisciplinary care of EAO-CRC.
The 2016 EAO CRC Summit featured keynote addresses from leading clinicians, epidemiologists and researchers from Europe, Africa, Australia and the nation's leading cancer centers and advocacy organizations.
The PowerPoint presentation that Dr. Andrew Varney, a general internist at SIU School of Medicine, will use at Thursday night's SIU Men's Night Out event.
As part of the IFPRI Egypt Seminar in partnership with the National Nutrition Committee (ASRT affiliated): "100 million healthy lives: Scientific evidence on the double burden of malnutrition in Egypt"
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. Obesity in children
Prevalence and Etiologies
GABY FALAKHA
PEDIATRICIAN -NEONATOLOGIST
DIU IN CHILD AND ADOLESCENT OBESITY
TRIPOLI APRIL 10TH
, 2018
3. Outline
1. Definition
2. Prevalence worldwide
3. Prevalence in Lebanon
4. Etiologies
Genetic
Endocrine
Social and behavioral
5. Take home messages
4. Definition
BMI : Body Mass Index
BMI= Weight (in Kg) / Height2
(in meters)
Overweight : BMI > 85th
percentile for age and gender
Obesity : BMI > 95th
percentile for age and gender
24. Obesity Trends* Among U.S. Adults
BRFSS, 2001
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
25. Obesity Trends* Among U.S. Adults
BRFSS, 2002
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
26. Obesity Trends* Among U.S. Adults
BRFSS, 2003
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
27. Obesity Trends* Among U.S. Adults
BRFSS, 2004
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
28. Obesity Trends* Among U.S. Adults
BRFSS, 2005
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
29. Obesity Trends* Among U.S. Adults
BRFSS, 2006
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
30. Obesity Trends* Among U.S. Adults
BRFSS, 2007
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
31. Obesity Trends* Among U.S. Adults
BRFSS, 2008
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
32. Obesity Trends* Among U.S. Adults
BRFSS, 2009
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
33. Obesity Trends* Among U.S. Adults
BRFSS, 2010
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
34. 2000
Obesity Trends* Among U.S. Adults
BRFSS, 1990, 2000, 2010
(*BMI ≥30, or about 30 lbs. overweight for 5’4” person)
2010
1990
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
52. Leptin deficiency
Leptin receptor deficiency is
a condition that causes
severe obesity beginning in
the first few months of life.
Affected individuals are of
normal weight at birth, but
they are constantly hungry
and quickly gain weight.
53. Melanocortin-4 receptor gene mutation
• The most frequent single-gene
cause of Obesity
• MC4 receptors are involved in
suppression of food intake by
α-melanocyte-stimulating
hormone
• Leads to massive obesity
• Present in 5% of persons with
severe obesity
54. Mutations in POMC
• Lack of central appetite
signaling and therefore
hyperphagia.
• Affected patients have red
hair and adrenal
insufficiency
58. Prader-Willi Syndrome
• Deletion in the proximal arm
of chromosome 15
• Diminished fetal activity
• Obesity
• Hypotonia
• Mental retardation
• Short stature
Hypogonadotropic
hypogonadism
• Strabismus
• Small hands and feet
59. Becwith-Wiedemann syndrome
An overgrowth disorder usually present
at birth, characterized by an increased
risk of childhood cancer and certain
congenital features.
Macroglossia
Macrosomia
Microcephaly
Midline abdominal wall defects
(omphalocele/exomphalos, umbilical hernia,
diastasis recti)
Ear creases or ear pits
Neonatal hypoglycemia
Hepatoblastoma
77. Examples of problematic social trends
Increase in use of motorized transport, e.g. to school.
Fall in opportunities for recreational physical activity.
Increased sedentary recreation.
Multiple TV channels around the clock, smartphones.
Greater quantities and variety of energy dense foods available.
Rising levels of promotion and marketing of energy dense foods.
Use of candies as a reward system
Larger portions of food offering better ‘value’ for money.
Rising use of soft drinks to replace water, e.g. in schools.
Air conditionning?
Obesity in children and young people: a crisis in public health
T. Lobstein, et al. for the IASO International Obesity Task Force
78. Marketing
Kellogg spent $22.2 million just on media advertising to
promote 139.8 million dollars' worth of sales in 2004
McDonald's spent $528.8 million on marketing to support
$24.4 billion in sales.
Budget for education about the risk hazards of obesity
“1 million dollars”
Since 1994, U.S. companies have introduced about 600 new
children's food products; half of them have been candies or
chewing gums, and another fourth are other types of
sweets or salty snack
81. POSSIBLE ROLE OF ADDED SUGARS IN CHILD OBESITY
The largest contributors of added sugars to American’s diets are
sugar-sweetened beverages (SSBs), and adolescents are the highest
consumers.
Total energy consumed by Americans ages 2 years and older comes
from added sugars : - 13.1 % in 1977
- 19.7 – 22.3 % in 1999
- 5-10% (recommended)
Mechanisms are :
1. Increased caloric intake
2. Insulin resistance
3. High glycemic index, rebound hyperinsulinemia and hypoglycemia
82. US trends in per capita calories from beverages
among children
F.B. Hu, V.S. Malik / Physiology & Behavior 100 (2010) 47–54 49
85. Screen time
A 2009 study on video game use found that the length of
game play time in a single sitting, frequency of video
game playing, and years of video game playing were
each correlated with less exercise and higher BMI
1. Decreased Energy Expenditure
2. Increased Consumption of Calories
3. Food advertising and product placement
4. Presence of TV in the bedroom
Ballard M, Gray M, Reilly J, et al. Correlates of video game screen time among
males: body mass, physical activity, and other media use. Eat Behav 2009; 10(3):161–7.
86. BMI and television viewing among over 2500
children aged 6–17 years in northern Greece
Krassas GE et al. Determinants of body mass index in Greek children and adolescents. J
Pediatr Endocrinol Metab 2001; 14 (Suppl. 5): 1327–1333.
88. • Mice receiving Penicillin
during weaning gained total
mass and fat mass in adult
age
• Mice receiving penicillin-
altered microbiata from 18
week-old penicillin treated
mice to 3 week-old Germ Free
Mice gained fat mass at a
significantly faster rate
Altering the intestinal microbiota during a critical
developmental window has lasting metabolic consequences
Cox et al. Cell. 2014 Aug 14;158(4):705-721
92. BPA : a chemical found in baby bottle
linked to increased risk of obesity
Analysing 61 studies investigating the link between BPA
exposure and weight and fat deposition, researchers from
Brunel University London, New York University and Vrije
University in Amsterdam discovered that exposure to BPA
during the development of mice and rats significantly
raised their risk of being overweight later in life.
93. The Lancet Planetary Health
Bisphenol A substitutes and obesity in US adults: analysis of a
population-based, cross-sectional study
Volume 1, Issue 3, June 2017, Pages e114-e122
Methods:
We included participants aged 20 years or older, who had available data on
concentrations of BPA, BPF, and BPS (n=1709), from a cross-sectional study,
the National Health and Nutrition Examination Survey 2013–14
Findings:
1521 participants were included in the analysis.
Higher BPA, BPF, and BPS concentrations were observed in adults who
were obese than adults who were not obese.
After adjustment for demographic, socioeconomic, and lifestyle factors,
and urinary creatinine concentrations, BPA, but not BPF or BPS, was
significantly associated with obesity (The OR for general obesity was 1·78)
94. Take home message
1. BMI should be measured periodically in all children
2. Child obesity is reaching alarming rates
3. Obesity is a multifactorial disease
4. Genetic and endocrine causes represent only 5% of all
etiologies
5. Social and behavioral etiologies are the main culprit.
6. Educating parents is an essential responsibility of
pediatricians
7. Better prevent than treat
95. Thanks for your attention
Questions?
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