5 Minutes With…:
Dr. Christie Ballantyne: Rimonabant and Cardiometabolic Risk
Dr. Christie Ballantyne

Dr. Ballantyne is Professor of Medicine in the Atherosclerosis Section at Baylor College of Medicine in Houston, Texas, where he also serves as Director of the Center for Cardiovascular Prevention. He has served on many steering committees and is Governor-Elect of the Texas chapter of the American College of Cardiology and a former president of the Houston chapter of the American Heart Association. Dr. Ballantyne has written and lectured extensively on vascular disease and has authored or coauthored many articles in various related fields. Dr. Ballantyne gave Bariatric Times five minutes, which is time enough for us to ask him some questions regarding rimonabant, one of the newest pharmacotherapies to hit the market.

Adolescent Surgery Perspective:
BARIATRIC SURGERY IN ADOLESCENTS- FDA Protocol for Adjustable Gastric Banding in Adolescent Clinical Trial at New Hope Pediatric & Adolescent Weight Management Project University of Illinois Chicago
Allen F. Browne, MD, and Nancy Tkacz Browne, RN, MS, CPNPThe current epidemic of childhood and adolescent obesity represents a significant health problem to our nation�s youth. It spans cultures, ethnicity, genders, socioeconomic levels, and communities. Obesity threatens all children�whether they are of normal weight or at the extreme end of the obesity spectrum. The primary goal of weight management policy is to prevent the development of obesity; however, if obesity is already present, the child requires a comprehensive approach to the management and resolution of obesity and its comorbidities. An increasing percentage of US adolescents are obese, and their obesity is a present and future problem.1 There is effective bariatric therapy for obese adolescents. How to apply this therapy requires a program aimed specifically at adolescents. The following article will outline the problem of adolescent obesity and describe the adolescent weight management program at the University of Illinois at Chicago, which utilizes the tool of the adjustab

Bariatric Center Spotlight:
The Bariatric Center at Georgetown Community Hospital, Georgetown, Kentucky
Cathi Roskind, RN Gynecology Perspective:
Ideal Permanent Contraception for the Obese Woman: The Essure� Option
by Robert M. Huster, MD, FACOG

Obesity presents several challenges in the healthcare of women. The impact is felt in both the medical and surgical care of the overweight or obese woman. It is common that heavy and or irregular menses occur due to annovulation, and resulting infertility may be an issue. Surgical procedures may be challenging and many times involve a significant increase in overall risk. Untoward events may include difficult endotracheal intubations, wound infections or separations, increased risk of thromboembolic events, and the possibility of postoperative atelectasis.

Interview:
with Henry Buchwald, MD, PhD Musculoskeletal Perspective:
The Facts on Osteoporosis: A Bariatric Surgery Perspective
Randal Hamilton, RN, MSN, FNP and Robin Blackstone, MD, FACS

People who suffer from morbid obesity are readily apparent to all of us. We all have friends, family, and coworkers who are afflicted with this disease. We know they have serious related comorbid diseases including hypertension, hypercholesterolemia, hyperlipidemia, degenerative disease of the weight-bearing joints, diabetes, cardiovascular disease, gastroesophageal reflux, stress urinary incontinence, and respiratory disorders, such as asthma, reactive airway disease, and sleep apnea. Osteoporosis rarely occurs in this group of people prior to surgery because carrying extra weight somewhat protects against bone loss. It is not until after surgery that osteoporosis becomes a health risk.

Nursing Perspective:
Certification for Bariatric Nurses: The Next Step!
by Melissa Davis, RN, MSN, ANP, CNS, CNOR, RNFA; and William Gourash, RN, MSN, CRNP, APRN, BC Nutrition Perspective:
Micronutrition for Wound Healing
by Jacqueline Jacques, ND

Plastic Surgery Perspective:
Brachioplasty in the Massive Weight Loss Patient
by Michel C. Samson, MD, FRCSC, FACS; Jeffrey Umansky, MD; and Martin I. Newman, MD

The growing popularity of bariatric surgical procedures in the United States has led to a rapidly increasing number of patients visiting the offices of plastic surgeons with problems related to excess skin and displaced body fat. A visit to any plastic surgery meeting will reflect this trend, with numerous new lectures and workshops on body contouring in the massive weight loss (MWL) patient. The MWL patient can present quite a challenge to the plastic surgeon, given the often extreme skin laxity present, and particularly in brachioplasty, where the �bat-wing� deformity often seen in the arms has greatly increased the demand for this surgery. In this article we discuss the germane issues associated with brachioplasty in the massive weight loss patient.

Risk Management Perspective:
Minimizing Risk Exposure in Bariatric Surgery
by Emily Wong-Swartz, MHSA, LHRM, RD, LD/NBariatrics is the branch of medicine dealing with the causes, prevention, and treatment of obesity, both pharmacological and surgical. Bariatric surgery is intended to treat patients who are at high risk for severe medical problems due to their excessive weight. It involves a variety of surgical approaches to restrict food intake when other treatments and lifestyle changes fail. Typically, a surgeon recommends surgery to a patient to treat a specific medical problem. The opposite is often true of bariatric surgery. In these cases, patients present to a surgeon requesting a specific procedure; however, not all patients who request bariatric surgery are appropriate candidates.1

Wound Care Perspective:
Bariatric Wound Care� Common Problems and Management Strategies
by Diane L. Krasner, PhD, RN, CWCN, CWS, FAAN; Karen Lou Kennedy-Evans, RN, CS, NP; and Therese �T� Henn, BSN, G/ANP-CSBariatric patients are at high risk for acute wounds, most notably nonhealing surgical wounds due to dehiscence or infection. They also are at higher risk for chronic wounds, such as pressure ulcers, venous ulcers, and diabetic foot wounds.1 This article is the second of two articles that review bariatric skin and wound care issues.2 In both situations, patient-centered interdisciplinary care is essential for successful outcomes. Underlying etiologies, complicating factors, and comorbidities must be identified and addressed. This concept of �advanced wound caring� requires commitment on the part of the healthcare team, patients, families, and caregivers.3