Hypothalamic Obesity in Children

WOS: 000387475400003Hypothalamic obesity (HyOb) is a severe and rapidly developing form of obesity that was initially described in patients with hypothalamic tumours and surgical damage. However, this definition has now expanded to include obesity developing after a variety of insults to hypothalamic centres, such as infections, infiltrations, trauma, vascular problems, and hydrocephalus in addition to acquired or congenital functional defects in central energy homeostasis. The pathogenetic mechanisms underlying HyOb are complex and multifactorial. Weight gain results from damage to the ventromedial hypothalamus, which may lead to hyperphagia, a low resting metabolic rate, autonomic imbalance, growth hormone, gonadotropin and thyroid-stimulating hormone deficiencies, hypomobility and insomnia. Disruption of leptin signalling and decreased central sympathetic output seem to have a critical role in the development of HyOb. Surgical strategies to preserve hypothalamic integrity are mandatory for the prevention of HyOb in patients with craniopharyngioma or other hypothalamic tumours. At present, there is no standard pharmacological intervention that has been shown to consistently help these complicated patients. In select cases, octreotide seems to be effective when introduced early after the cranial insult. The safety and effectiveness of bariatric surgery in the management of HyOb has also not been well established. A general overview on HyOb with special emphasis on craniopharyngioma and Prader-Willi syndrome is provided in this chapter. (C) 2015 S. Karger AG, Base

IMPROVING ACCESS TO COLLECTIONS FOR SAMPLING

The commitment to increasing access to collections has resulted in concepts such as ‘acceptable’ rates of damage. This new pragmatism has yet to be developed into a consistent approach to access for analysis. This paper uses a case study of the scientific examination of early Greek copper alloy helmets to illustrate a range of problems encountered by researchers. In the context of the case study it considers national and political criteria, the policies and procedures of museums and professional ethical codes. The paper also considers additional barriers that can be encountered by younger researchers, who may be considered less credible than their more established colleagues, and discusses strategies that they can use to increase the likelihood of gaining access to samples

The 'redefinition of death' debate: western concepts and western bioethics.

Biomedicine is a global enterprise constructed upon the belief in the universality of scientific truths. However, despite huge scientific advances over recent decades it has not been able to formulate a specific and universal definition of death: In fact, in its attempt to redefine death, the concept of death appears to have become immersed in ever increasing vagueness and ambiguity. Even more worrisome is that bioethics, in the form of principlism, is also endeavouring to become a global enterprise by claiming neutrality. It appears that the discourse within both disciplines have similarly manipulated the boundaries of death to include the "dying". This paper argues that the redefinition of death debate in biomedicine reveals a concept of personhood which is profoundly western in origin and which is in accordance to the concept adhered to within principlism. Biomedicine and bioethics do not appear to acknowledge the limitations of their own world view and hence lack an understanding of their applicability and appropriateness in diverse social and cultural contexts; a situation which adds credence to claims as to the hegemonic and imperialistic nature of all such global enterprises