Prevalence of asthma related to BMI in adolescents in Tehran, Iran, 2004–2005

Both asthma and obesity have become more common in affluent societies during the recent decades, and several studies have shown a correlation between the presence of asthma and obesity.     

Prevention of anemia in the first year of life in health centers of Santo André, São Paulo

The aim of this study was to evaluate the efficacy of an iron prophylactic supplementation program, in three health centers of Santo André, in S?o Paulo state. The prevalence of anemia was identified in a control group consisting of 201 children of 1 year old. The intervention group consisted of 308 children younger than 3 months, but 55% of them gave up during the survey. The mothers were instructed to give them daily prophylactic doses of iron sulfate (6 mg of iron/day) when they were 4 or 6 months old, according to the kind of breast-feeding. The mothers were also instructed about feeding and anemia and its risk to children's health. When the children were 12 months old, the diagnosis of anemia was made through dosage of hemoglobin concentration and the results were compared with those of the control group. It was verified that the 2 groups presented similar prevalences. It is important to realize that children with low frequency of visits to the health centers had prevalence of anemia significantly higher than those with high frequency. Some factors that possibly contributed to the result of the intervention are discussed.     

Patterns of childhood mortality in a region of Belarus, 1980–2000

The public health infrastructure of the former Soviet Union was impacted by both the Chernobyl disaster in 1986 and the Soviet breakup in 1991. This paper examines mortality patterns among children aged 1–14 years within the Mogilev region of Belarus between 1980 and 2000. This study utilized a regional cohort design that included all childhood deaths (ages 1–14 years) occurring among persons residing within the Mogilev oblast of Belarus between 1980 and 2000. Patterns of death and death rates were examined across three intervals: 1980–1985 (pre-Chernobyl), 1986–1991 (post-Chernobyl and pre-Former Soviet Union (FSU) breakup) and 1992–2000 (post-Chernobyl and post-FSU breakup) based upon administrative death files. Annual death rates among children aged 1–4 years declined between 1980 and 2000, while mortality rates among children aged 5–9 years and 10–14 years remained steady over this time period. Average annual mortality rates among males aged 5-9 years and 10–14 years increased significantly between 1986 and 1991. Compared to the baseline interval, mortality among both males and females aged 1–4 years was significantly decreased during 1986–1990 and 1992–2000. In general, mortality rates among males were 24%–95% greater compared to females. Injuries and poisonings accounted for the largest proportion of deaths across all age and gender groups examined. Subsequent to the Chernobyl disaster, significant decreases were noted in mortality rates among children aged 1–4 years while mortality rates among children aged 5–9 and 10–14 remained stable. Conclusion: Similar to the findings in other countries, injuries and poisonings predominated as the leading cause of death among Belarussian children.     

Rotavirus subgroups, G serotypes, and electrophoretypes in cases of nosocomial infantile diarrhoea in Belém, Brazil.

From November 1992 to November 1994 stool samples were obtained from 237 children admitted to a public hospital in Belém. Rotaviruses were detected in 19.3 per cent (60/310) of faecal samples. Of these, 32.1 per cent (18/56), 20.9 per cent (38/181), and 5.4 per cent (4/73) were recorded in cases of nosocomial diarrhoea, community-acquired diarrhoea, and controls, respectively. Fifty-two (86.7 per cent) of the 60 rotavirus-positive specimens were subgrouped and the G serotypes of 55 (91.7 per cent) of them were determined. Subgroups I and II were detected in 50 per cent each of the 52 subgrouped strains. G type 2 was present in 46 (83.6 per cent) of the 55 serotyped samples; serotypes G1 and (mixed) G1 and G4 were found in 14.5 per cent and 1.8 per cent, respectively, of these specimens. Viral RNA electrophoresis showed 14 distinct patterns, including 56.7 per cent (34/60) and 43.3 per cent (26/60) of long and short profiles, respectively. In 40 (66.6 per cent) of the 60 rotavirus-positive faecal samples no enteropathogens other than rotavirus were detected. There was an increased incidence of rotavirus infection from July 1993 to February 1994. The rotavirus-related episodes of diarrhoea were more severe than those of other aetiology and greater clinical severity was not related to a specific G type, subgroup, or electrophoretype.     

Outcomes of pediatric gastroesophageal reflux disease: in the first year of life, in childhood, and in adults...oh, and should we really leave Helicobacter pylori alone?

The prevalence of gastroesophageal reflux (GER) in childhood varies by age. As in adults, GER can result in a spectrum of disease manifestations. Children with gastroesophageal reflux disease (GERD) may become adults with GERD, as suggested by the frequency of childhood reflux symptoms reported by adults with reflux disease. Some studies suggest a causative association between Helicobacter pylori infection and GERD, whereas others postulate a protective role for H. pylori. To better understand pediatric GERD, age-appropriate case definitions and multicenter randomized controlled treatment trials are critically needed.     

Pharmacodynamics and pharmacokinetics of esmolol,a short-acting β-blocking agent,in children

Summary Esmolol, a short-acting intravenous cardioselective -blocking agent, was evaluated for age-dependent pharmacodynamic and pharmacokinetic features in 17 young patients (6 months to 14 years). A loading dose (500 g/kg/min) alternating with a maintenance dose (25–200 g/kg/min, titrating by 25 g/kg/min every 4 min) was infused until the heart rate or mean arterial pressure decreased 10%. Cardiac index, left ventricular shortening fraction, and systemic vascular resistance were measured at baseline, peak esmolol effect, and recovery. Serum esmolol concentrations were obtained to determine the half-life and the elimination rate constant.Esmolol reduced the heart rate, blood pressure, shortening fraction, and cardiac index in all patients, but it did not change systemic vascular resistance. Maintenance esmolol dose was 118 ±49 g/kg/min, and the half-life was 2.88±2.67 min. Blood pressure and heart rate returned to normal within 2–16 min, but cardiac index and shortening fraction took longer to recover. There were no statistically significant age-dependent pharmacodynamic effects, but blood pressure decreased prior to heart rate and cardiac index took longer to recovery in patients who weighed15kg. The pharmacokinetic profile in young patients was similar to that of older patients, but the half-life was shorter. The only side effeect was transient nausea and vomiting in one patient. Esmolol is a safe and efficacious -blocking agent in young patients.     

Evaluation of the Malnourished Children's Recuperation Program in the town of Embu, located in the Metropolitan Area of São Paulo

The objective of this study is to assess the anthropometric evolution of children who had been assisted by the Malnourished Children's Recuperation Program in the town of Embu, as well as to analyze some variables that interfered in this evaluation. The study included 233 children aged under five, enrolled in the program from January 1984 to December 1985. 201 (86,3%) were undernourished grade II and 32 (13,7%) grade III, according to Gomez. The percentage increase of Weight in relation to Age (W/A) and Height in relation to Age (H/A) - outcome variables, in the first and last examinations in the program - were analyzed, using the multiple linear regression. Younger children and in worse nutritional conditions showed higher W/A and H/A increases. Low birth weight, more frequent examinations, and longer stay in the program were associated to lower W/A increases. The presence of chronical pathologies jeopardized the H/A rate increases. This result strengthens the importance of developing programs for the assistance of undernourished children, due to higher risk of morbi-mortality in this group, mainly in younger children and with worse nutritional conditions.     

Role of cytokine gene (IFN-γ, TNF-α, TGF-β1, IL-6, and IL-10) polymorphisms in pathogenesis of acute rheumatic fever in Turkish children

Acute rheumatic fever (ARF) is a delayed immunologically mediated sequela of throat infection by group A β-hemolytic streptococci. Inflammatory cytokines may play a pathogenic role in ARF. The objective of this study was to investigate the potential associations between interferon (IFN)-γ, interleukin (IL)-6, tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-β1, and IL-10 gene polymorphisms and childhood ARF. Thirty-eight ARF patients and 40 age- and sex-matched healthy controls were analyzed for eight polymorphisms in five different cytokine genes [IFN-γ (+874), IL-6 (-174), TNF-α (-308), TGF-β1 (+10, +25), and IL-10 (-1082, -819, -592)]. Cytokine genotyping was performed by polymerase chain reaction sequence-specific primer methods. Patients with ARF had significantly higher frequencies of IFN-γ (+874) polymorphism in both TT genotype (p=0.0002) and T allele (p=0.0004). No statistically significant differences were observed in genotypes, haplotypes, and allele frequencies of IL-6, TNF-α, TGF-β1, and IL-10 genes between ARF and control groups (p>0.05). GG genotype frequency of TNF-α gene (low expression) was higher in patients who had previous ARF history (p=0.006). High expression of TGF-β1 (TT/GG, TC/GG) was more frequent in patients with CRP positivity (p=0.034). IL-6 CC genotype (low expression) frequency was higher in patients with tricuspid valve insufficiency (p=0.002), while IFN-γ TT genotype (high expression) frequency was higher in patients with mitral valve prolapse (p=0.049). Conclusion: High expression of the IFN-γ gene may carry a higher risk for ARF in Turkish children, while IL-6, TNF-α, and TGF-β1 may have an impact in mediating some clinical and laboratory manifestations of the disease.     

Diagnosis and prognosis of wheezing disorders in young children in the city of São Paulo, Southeast Brazil

Three‐hundred‐and‐ninety‐seven children aged 2–59 mo presenting to the paediatric emergency departments of five public hospitals in São Paulo, Brazil, with an acute episode of lower respiratory disease were examined. The children were classified into the following diagnostic categories: acute bronchitis, acute bronchiolitis, pneumonia, asthma, post‐bronchiolitis wheezing and wheezing of uncertain aetiology. Three years after the initial study, the homes of the children diagnosed as asthmatic or as having wheezing of uncertain aetiology were visited to collect information on subsequent episodes of lower respiratory disease. This paper reports the proportional incidence of different categories of lower respiratory disease and the results of an analysis to investigate clinical features that might distinguish wheezing children between those with asthma and those with an infectious disease. The predictions made for children with wheezing of uncertain aetiology were then compared with the follow‐up data. Recurrent wheezing disorders (asthma, post‐bronchiolitis wheezing) were common in the study sample (47% of children). Thirty‐six percent of children with an initial diagnosis of wheezing of uncertain aetiology were diagnosed as asthmatic by another doctor over the next 3 y. We were unable to identify any clinical features that were useful in identifying those children likely to be diagnosed subsequently as asthmatic. Conclusions: The use of a diagnostic category similar to that which we have called “wheezing of uncertain aetiology” might help to alert physicians early to the possibility of asthma without interfering in the management of the illness. Such a classification might also be useful in epidemiological investigations of the aetiology of lower respiratory diseases.     

Growth, nutritional status, and signs of rickets in 0–5-year-old children in a Kashin–Beck disease endemic area of Central Tibet

In order to describe the growth of 0-5-year-old Tibetan children living in a Kashin-Beck disease (KBD) endemic rural area and to examine the relationship between anthropometric indicators and clinical signs of rickets, we analyzed the baseline data of a cohort of 668 children enrolled in a prospective program of calcium and vitamin D supplementation. Tibetan children suffer from growth retardation. Z score of weight-for-age, height-for-age, weight-for-height was below -2 in 32.5%, 27.7%, and 12.1% of the children, respectively. Clinical signs of severe rickets are highly prevalent. Underweight, stunting, and clinical rickets increases with age. Prevalence of malnutrition was higher in the presence of signs of rickets. The proportion of children with a head circumference Z score?相似文献   

Increasing prevalence of overweight in young schoolchildren in Umeå, Sweden,from 1986 to 2001

Aim: To investigate the current prevalence and trend of overweight in young schoolchildren in Umeå, Sweden. Methods: Two cross‐sectional samples of children were studied: 1115 randomly selected children from preschool class to grade 6 (aged 6–13 y) attending school in 2001 and a matched sample of 507 schoolchildren from grades 0, 1 and 4 (aged 6–11 y) attending school in 1986. Overweight was defined according to age‐ and gender‐specific body mass index (BMI) cutoff values, corresponding to BMI values of 25 kg/m² (level 1) and 30 kg/m² (level 2) at late adolescence. Results: In the population from 2001, the prevalence of overweight was 23% (18% at level 1, 5% at level 2). The prevalence differed with age, with a higher prevalence at the ages of 6 and 13 y. Comparing children from grades 0, 1 and 4, attending school in 1986 and 2001, respectively, the total prevalence of overweight was twice as high in 2001 as in 1986. Regarding severe overweight (level 2), the difference was even larger (five times). In the 1986 sample, the prevalence of overweight did not differ between girls and boys, while significantly more girls than boys were overweight in 2001. Conclusion: In this sample of young children from Sweden, the prevalence of overweight doubled over the past 15 y and severe overweight increased even more, suggesting a need for intensified preventive efforts in young schoolchildren.