Associations between social support,psychological well‐being,decision making,empowerment, infant and young child feeding,and nutritional status in Ugandan children ages 0 to 24 months

Maternal capabilities—qualities of mothers that enable them to leverage skills and resources into child health—hold potential influence over mother's adoption of child caring practices, including infant and young child feeding. We developed a survey (n = 195) that assessed the associations of 4 dimensions of maternal capabilities (social support, psychological health, decision making, and empowerment) with mothers' infant and young child feeding practices and children's nutritional status in Uganda. Maternal responses were converted to categorical subscales and an overall index. Scale reliability coefficients were moderate to strong (α range = 0.49 to 0.80). Mothers with higher social support scores were more likely to feed children according to the minimum meal frequency (odds ratio [OR] [95% confidence interval (CI)] = 1.38 [1.10, 1.73]), dietary diversity (OR [95% CI] = 1.56 [1.15, 2.11]), iron rich foods, (OR [95% CI] = 1.47 [1.14, 1.89]), and minimally acceptable diet (OR [95% CI] = 1.55 [1.10, 2.21]) indicators. Empowerment was associated with a greater likelihood of feeding a minimally diverse and acceptable diet. The maternal capabilities index was significantly associated with feeding the minimum number of times per day (OR [95% CI] = 1.29 [1.03, 1.63]), dietary diversity (OR [95% CI] = 1.44 [1.06, 1.94]), and minimally acceptable diet (OR [95% CI] = 1.43 [1.01, 2.01]). Mothers with higher psychological satisfaction were more likely to have a stunted child (OR [95% CI] = 1.31 [1.06, 1.63]). No other associations between the capabilities scales and child growth were significant. Strengthening social support for mothers and expanding overall maternal capabilities hold potential for addressing important underlying determinants of child feeding in the Ugandan context.     

Hemoglobinopathies in the District of Antalya, Turkey

A screening program was conducted to ascertain the incidence of hemoglobinopathies in the district of Antalya, Turkey. The survey sample was selected from the household registration forms of health centers by systematic random sampling. Heparinized blood samples were collected from 1,616 subjects from 884 families.

The prevalence of p thalassemia traits with increased Hb A2 was 10.2%. This is higher than that found in previous studies performed in Antalya. The prevalence of abnormal hemoglobins (Hbs) was found to be 0.8%. Four subjects had Hb AS; five had Hb D-Los Angeles (B 121 [GH4] Glu-Gln); one had Hb Ube-2 (68 [E1] Asn-Asp), one had Hb P-Nilotic (fusion between B 22 and) and two had Hb D-like variants.     

A noninvasive, sensitive, specific, and reliable approach to assess whole-body nitric oxide synthesis in children

Determination of nitric oxide (NO) synthesis in vivo is essential to understand the pathophysiologic role and therapeutic implications of the L-arginine/NO pathway in pediatric diseases. The aim of this study was to establish a noninvasive, sensitive, specific, and reliable approach to determine whole-body NO synthesis in healthy children. Seventeen healthy children (eight boys/nine girls, 4-16 y) were studied twice, and six of them on three occasions. Fasting children received a single oral dose of nonradioactive L-[15N]2-guanidino arginine (5 mg/kg body weight). Complete 24-h urine collections were subsequently performed on an ambulatory basis. Total urinary nitrate excretion and [15N]nitrate enrichments were determined using high-pressure liquid chromatography and gas chromatography-isotope ratio mass spectrometric techniques. The mean urinary [15N]nitrate enrichments on the 0-12-h/12-24-h collection periods of three study visits were 0.9309%/0.5910%, 0.9056%/0.6214%, and 0.9087%/0.6059%. The levels of 24-h urinary [15N]nitrate excretion [mean (95% confidence interval)] for three study visits were 11.70 (8.85-14.54), 12.21 (9.61-14.82), and 11.37 (7.96-14.77) microg [15N]nitrogen-nitrate/mmol creatinine, respectively. Within-subject coefficient of variation for 24-h urinary [15N]nitrate excretion was 11.87%. Agreement among results was assessed by intraclass correlation coefficient (0.93) and coefficient of repeatability (4.08). The percentage of L-[15N]2-guanidino arginine dose directed to nitric oxide synthesis was 0.221% [0.181-0.261]. Multiple regression analysis showed age as the predictor variable of whole-body NO synthesis. These results show for the first time that a single oral administration of L-[15N]2-guanidino arginine can be used to reliably and specifically determine whole-body NO synthesis in children.     

Community neonatal practices and its association with skilled birth attendance in rural Haryana,India

Aim: The study aimed to document home-based neonatal care practices and their association with type of birth attendance. Methods: This study was conducted in rural Haryana on mothers who had delivered a live baby one to 2 months prior to interview. The study instrument, administered through home visits, had questions related to cord care, breastfeeding, thermal care, baby handling and healthcare seeking. Logistic regression was performed to test for association [OR; 95% CI] of key newborn care practices with skilled birth attendance. Results: Of the 415 mothers interviewed, 26.7% applied nothing on umbilicus; 15% were kept in skin-to-skin contact with mother; 20.2% were exclusively breastfed in first month. Seeking care in private sector and cost incurred in the treatment for a neonatal illness was significantly higher for male babies. Delivery by skilled birth attendant (68.5%) was associated with applying nothing on the cord [1.8; 1.01–3.25], in skin-to-skin contact with mother for ≥6 h a day [2.21; 1.18–4.13], bathing the baby after third day [14.63; 6.85–31.21] and exclusive breastfeeding [8.84; 3.42–22.8]. Conclusion: The results of this study call for not only upscaling skilled birth attendance but also improving the quality of care currently provided.     

Ineffectiveness of Lactobacillus GG as an adjunct to lactulose for the treatment of constipation in children: a double-blind, placebo-controlled randomized trial

OBJECTIVE: To determine if Lactobacillus GG (LGG) is an effective adjunct to lactulose for treating constipation in children. STUDY DESIGN: Eighty-four children (2-16 years of age) with constipation (<3 spontaneous bowel movements [BMs] per week for at least 12 weeks) were enrolled in a double-blind, randomized placebo-controlled trial in which they received 1 mL/kg/day of 70% lactulose plus 10 9 colony-forming units (CFU) of LGG (experimental group, n = 43) or a placebo (control group, n = 41) orally twice daily for 12 weeks. The primary outcome measure was treatment success, and analyses were performed on an intention-to-treat basis. RESULTS: Treatment success, defined as >or=3 spontaneous BMs per week with no fecal soiling, was similar in the control and experimental groups at 12 weeks (28/41 [68%] vs 31/43 [72%], respectively; P = .7) and at 24 weeks (27/41 [65%] vs 27/42 [64%], respectively; P = 1.0]. Groups also did not differ in their mean number of spontaneous BMs per week or episodes of fecal soiling per week at 4, 8, and 12 weeks. Adverse events and overall tolerance did not differ between groups. CONCLUSION: LGG, as dosed in this study, was not an effective adjunct to lactulose in treating constipation in children.     

Characterizing the relationship between sesame,coconut, and nut allergy in children

Stutius LM, Sheehan WJ, Rangsithienchai P, Bharmanee A, Scott JE, Young MC, Dioun AF, Schneider LC, Phipatanakul W. Characterizing the relationship between sesame, coconut, and nut allergy in children.
Pediatr Allergy Immunol 2010: 21: 1114–1118.
© 2010 John Wiley & Sons A/S Sesame and coconut are emerging food allergens in the United States. We sought to examine whether children allergic to peanuts and tree nuts are at increased risk of having an allergy to sesame or coconut. We performed a retrospective chart review of children who underwent skin prick testing (SPT) to sesame and coconut and identified 191 children who underwent SPT to sesame and 40 to coconut. Sensitization to sesame was more likely in children with positive SPT to peanuts (odds ratio [OR] = 6.7, 95% confidence interval [CI] [2.7–16.8], p < 0.001) and tree nuts (OR = 10.5, 95% CI [4.0–27.7], p < 0.001). Children with histories of both peanut and tree nut reaction were more likely to have a history of sesame reaction (OR = 10.2, 95% CI [2.7–38.7], p < 0.001). Children with sensitization or allergy to peanuts or tree nuts were not more likely to be sensitized or allergic to coconut. In conclusion, children with peanut or tree nut sensitization were more likely to be sensitized to sesame but not coconut. Children with clinical histories of both peanut and tree nut allergy were more likely to be allergic to sesame.     

Intellectual outcome, motor skills and BMI of children with congenital hypothyroidism: a population-based study

AIM: To evaluate intellectual outcome, motor skills and anthropometric data of children with congenital hypothyroidism (CH). METHODS: Children with permanent CH who were born in 1999 in Bavaria were eligible for this prospective, population-based study. Cognitive performance was evaluated by the Kaufman Assessment Battery for Children and motor skills were assessed by the motor test, Motoriktest für vier-bis sechsjahrige Kinder (MOT) 4-6. RESULTS: Eighteen of 21 eligible children participated (86%). Median age of the children was 5.5 years (range 4.9-5.8). Treatment with levothyroxine was started after a median of 7.2 days (range 4-15) with a median dose of 12.0 microg/kg (range 7.2-17.0). Mean intelligence quotient (IQ) of the children was 100.4 (standard deviation [SD] 10.1): no children had IQ values below the normal range. Reactivity and speed of movement were significantly reduced in children with CH. Children with an initial thyroid-stimulating hormone (TSH) value of >200 mU/L performed significantly worse than children with TSH value of 相似文献   

Pediatric acute liver failure: Etiology,outcomes, and the role of serial pediatric end‐stage liver disease scores

To describe etiology, short‐term outcomes and prognostic accuracy of serial PELD scores in PALF. Retrospective analysis of children aged ≤16 yr, admitted with PALF under the QLTS, Brisbane, Australia, between 1991 and 2011. PELD‐MELD scores were ascertained at three time points (i) admission (ii), meeting PALF criteria, and (iii) peak value. Fifty‐four children met criteria for PALF, median age 17 months (1 day–15.6 yr) and median weight 10.2 kg (1.9–57 kg). Etiology was known in 69%: 26% metabolic, 15% infective, 13% drug‐induced, 6% autoimmune, and 9% hemophagocytic lymphohistiocytosis. Age <3 months and weight <4.7 kg predicted poor survival in non‐transplanted children. Significant independent predictors of poor outcome (death or LT) were peak bilirubin > 220 μm /L and peak INR > 4. Serial PELD‐MELD scores were higher in the 17 (32%) transplant recipients (mean: [i] 26.8, [ii] 31.8, [iii] 42.6); highest in the 12 (22%) non‐transplanted non‐survivors (mean: [i] 31.6, [ii] 37.2, [iii] 45.7) compared with the 25 (46%) transplant‐free survivors (mean: [i] 25.3, [ii] 26.0, [iii] 30.3). PELD‐MELD thresholds of ≥27 and ≥42 at (ii) meeting PALF criteria and (iii) peak predicted poor outcome (p < 0.001). High peak bilirubin and peak INR predict poor outcome and serial PELD‐MELD is superior to single admission PELD‐MELD score for predicting poor outcome.     

Alterations in sleep physiology in young children with insulin-dependent diabetes mellitus: relationship to nocturnal hypoglycemia

OBJECTIVES: To examine the effect of diabetes per se and nocturnal hypoglycemia on sleep in children with insulin-dependent diabetes mellitus (IDDM). DESIGN: Overnight polysomnography was performed on 3 occasions in 29 children with IDDM - twice during metabolic profiling. Sleep data were analyzed from 14 children (median [range], 8.7 [5.9 to 12.9] years) with a night of hypoglycemia and a nonhypoglycemic night. Seven children in the control group (9 [5.6 to 11.4] years) underwent 2 nights of polysomnography, once during metabolic profiling (to assess the effects of metabolic profiling), and 15 members of the control group had polysomnography only (to assess the effects of diabetes per se and to compare with the index group). RESULTS: Children with IDDM had disrupted sleep compared with the control group (short wakes, percentage of sleep time, 0.8 [0.5 to 1.9] vs 0.0 [0.0 to 0.3], median [interquartile range], IDDM vs control group, respectively, P =.001; long wakes, 1.2 [0.7 to 3. 0] vs 0.0 [0.0 to 0.0], P =.033; total number of wakes, 6 [3.5 to 11. 5] vs 1 [0 to 2], P =.002). Blood sampling disrupted sleep with increased long wakes as percentage of sleep time (0.3 [0.0 to 3.8] vs 4.3 [3.1 to 16.9], nonsampling vs sampling night, respectively, P =.003). Episodes of hypoglycemia were profound, with a glucose nadir of 2.0 [1.4 to 3.3] mmol/L (35.0 [24.5 to 57.8] mg/dL) and prolonged, 308 [30 to 630] minutes, with no effect on sleep. CONCLUSIONS: Children with diabetes had disrupted sleep compared with a control group, but there was no effect of profound nocturnal hypoglycemia on sleep quality. J Pediatr 2000;137:233-8)     

2001至2005年上海1 450份住院患儿A组轮状病毒分子流行病学研究

目的 对2001至2005年上海地区住院患儿A组轮状病毒分子流行病学进行研究，为今后轮状病毒疫苗的研制和应用提供基础数据和理论依据。方法 从复旦大学附属儿科医院2001至2005年住院的腹泻婴幼儿1450份轮状病毒抗原阳性粪便标本中用机械抽样的方法随机抽取363份，建立套式RT-PCR的方法，从粪便中检测轮状病毒基因并进行G和P型别的分型。结果 轮状病毒腹泻的主要流行季节是10~12月份，2岁以内的患儿占全部患儿总数的79.9%（290/363）。G1型所占比例在2001年最多为28.8%（25/87），以后逐年下降至2004年的1.7%（1/60），但2005年又回升至7.0%（4/57）。G3型在5年间均是最主要的流行型别。存在但少见的流行型别是G2和G4型，2001和2002年分别为14.9%（13/87）和5.0%（5/100）。每年的主要流行株均为P［8］，不同年份尚流行少量的P［4］和P［6］型。G3 P［8］成为2001至2005年上海地区的主要轮状病毒流行株，其次的流行型别包括2001和2003年份的G1 P［8］，2002年的G3、P混合型，2004至2005年的G3、P未知型。结论 2001至2005年上海地区轮状病毒流行型别显示了一定的变化规律，G3、P［8］ 及其组合G3 P［8］是5年间上海地区的主要轮状病毒流行株，不同年份尚有一些其他已知和未知型别的流行。     

Comparative study of the binding of prolactin and growth hormone by rabbit and human lung cell membrane fractions.

The specific binding capacities for human prolactin (hPRL) and human growth hormone (hGH) were examined in human lung membrane preparations at different developmental stages. A parallel study was carried out on rabbit lung preparations to compare binding parameters. Lung tissues were obtained from 15 fetuses of 16-38 weeks after spontaneous or therapeutic abortion and from 7 adults (lobar resection surgery). A histological study was systematically performed with a radial alveolar count in the fetuses with suspected hypoplasia. Binding analysis was performed on both intact membrane preparations and MgCl2-treated membranes, using [125I]hGH and [125I]hPRL as tracers. In the rabbit lung, specific [125I]hGH binding was found. Scatchard analysis revealed a single class of binding sites (affinity constant: 2.6 +/- 0.8 x 10(9) l/nmol and number of binding sites: 9.5 +/- 4.3 fmol/mg protein for adult rabbit; 1.85 +/- 0.5 x 10(9) l/nmol and 27.6 +/- 3.0 fmol/mg protein for 25-day-old rabbit fetuses, respectively). In contrast, [125I]hPRL did not specifically bind to lung membrane preparations. In the human lung, no consistent specific binding sites for [125I]hPRL or [125I]hGH (less than 0.5%/mg protein) were detected in adults and in 11 of the 15 fetuses. In 4 fetuses, little specific binding was observed (0.59-1.9%/mg protein) for [125I]hGH and (1.5%/mg protein) for [125I]hPRL. There was no correlation with histological lung structure. Our findings confirm the presence of specific binding sites for GH in the adult rabbit lung and demonstrate such binding in the fetal rabbit lung. In contrast, our results showed no significant binding for PRL and GH in the human lung, suggesting that these hormones do not play a direct physiological role in human lung growth and maturation.     

Propranolol therapy of infantile hemangiomas: efficacy, adverse effects, and recurrence

Objective

To evaluate the efficacy, adverse effects, and recurrence of oral propranolol for treatment of infantile hemangioma.

Methods

Participants were treated with oral propranolol three times daily, with inpatient monitoring of adverse effects. The starting dosage was 2 mg/kg per day, which had been for the remaining duration of treatment. Therapy duration was planned for 4–6 months; if there was significant relapse, the period of treatment was extended. A photograph based severity scoring assessment was performed by three observers to evaluate efficacy by visual analog scale (VAS).

Results

Sixty-one infants [median age 3.3 (1.2–8.1) months] were included in the study. The median follow-up-time was 15 (6–20) months and 53 patients completed treatment at a median age of 10.3 (8.4–18.1) months, after a duration of 8.5 (4.5–14) months. In all patients, there was significant fading of color [with a VAS of ?9 (?6 to ?9) after 6 months] and significant decrease in size of the infantile hemangiomas [with a VAS of ?8 (?3 to ?10) after 6 months]. We did not observe any life-threatening adverse effects. The therapy was interrupted due to temporary aggravation of pre-existing bronchial asthma in one child. Four cases presented partial recurrences.

Conclusions

Oral propranolol 2 mg/kg per day was a well-tolerated and effective treatment, mild adverse effects, and low recurrence for infantile hemangiomas. Propranolol should now be used as a first-line treatment in hemangiomas when intervention is required. Also, prospective studies should be needed in determining the most effective treatment dosage, optimum treatment duration, and exact mechanism of action of propranolol in future.     

Immunologic disturbances in cow's milk allergy, 1: delayed maturation of suppressor activity

To assist in identifying pathogenetic mechanisms in different subtypes of cow's milk allergy (CMA), the function of immunoregulatory T-lymphocytes was studied. The study population consisted of 23 patients, mean [95% confidence interval] age of 25. 6 [19. 5, 33. 6] months, who had challenge-proven cow's milk allergy manifested with either skin (n=9) or gastrointestinal (n=14) symptoms; in addition, 13 age-matched disease controls were studied. Patients with challenge-proven CMA were rechallenged to establish whether they had acquired clinical tolerance to cow's milk. The suppressor activity of isolated lymphocytes was measured in vitro by a cell coculture at rechallenge and in 10/23 patients at diagnosis. At diagnosis, patients with CMA (n=10) showed a decreased mean [95% CI] suppressor activity, induced by either Concanavalin A, 7[-2, 15]%, or cow's milk, 3[-8, 14]% as compared with disease controls (n = 13), 19[15, 24]% and 24[17, 31]%; F = 7. 1, p = 0.004 and F = 6. 7, p = 0.005, respectively. At rechallenge the suppressor activity, induced both by Concanavalin A and cow's milk, reached the level of disease controls only in patients who had acquired clinical tolerance to cow's milk (n = 13/23), but not in those retaining CMA (n = 10/23). Our results indicate that the maturation of suppressor function is delayed in CMA, which might be of primary importance in the etiopathogenesis of CMA.     

Normal ranges of continuous pH monitoring in the proximal esophagus

BACKGROUND: To determine normal ranges of gastroesophageal reflux (GER) in the proximal esophagus, measured with continuous pH monitoring. Normal ranges in the distal esophagus have been published. Because esophageal pH monitoring is frequently performed in children with atypical manifestations such as chronic respiratory disease, and because one of the possible pathophysiologic mechanisms may be (micro-)aspiration, it may be relevant to establish normal ranges in the proximal esophagus. METHODS: Twenty-four-hour pH monitoring was performed in 200 children with suspected GER disease. The mean age of the patients was 4.5 months (range, 0.5-17.0 months). After initial analysis, patients were divided into three groups according to the reflux index (RI) in the distal esophagus, because it could be speculated that the amount of reflux reaching the proximal esophagus depends on the amount of reflux in the distal esophagus: Group I (n: 120) children had a distal RI of less than 5% and were considered normal, group II (n:50) had a distal RI of 5% to 10% and was considered to have intermediate disease, and group III (n:30) had a distal RI of more than 10% and was regarded as pathologic. The following parameters are calculated: the RI, the total number of reflux episodes, the number of reflux episodes lasting more than 5 minutes, the duration of the longest reflux episode, and the acid clearance time (ACT). RESULTS: The median RI in the distal esophagus was 3.8 +/- 0.34 (standard error of the mean [SEM]), and in the proximal esophagus, the RI was 1.2 +/- 0.23. In group I patients, the RI in the proximal esophagus was 0.5% +/- 0.09%, in group II the RI increased significantly to 2.75% +/- 0.34% (P [group I compared with group II] < 0.01), and in group III the RI was 6.15% +/- 0.96% (P [II-III] < 0.01). The number of acid reflux episodes in group I was 17.0 +/- 2.27, in group II the number increased to 62.5 +/- 8.18 (P [I-II] < 0.01), and in group III it reached 102.0 +/- 23.9 (P [II-III] < 0.05). Also the duration of the longest reflux episodes and the number of reflux episodes lasting more than 5 minutes increased from group I to group II, and from group II to group III. The ACT was shorter in the proximal esophagus (group I 0.3 +/- 0.06 minutes; group II 0.48 +/- 0.07 minutes, P [I-II] = not significant [NS]; group III 0.56 +/- 0.17 minutes P [II-III] = NS) than in the distal esophagus (group I 0.49 +/- 0.03 minutes, P [proximal ACT compared with distal ACT] < 0.05; Group II 0.76 +/- 0.05 minutes, P [proximal-distal] < 0.01; Group III 0.89 +/- 0.09 minutes, P [proximal-distal] = NS) suggesting more effective esophageal clearance in the proximal esophagus. CONCLUSIONS: Protection of the proximal esophagus from acid reflux is significantly related to the incidence and duration of reflux measured in the distal esophagus. These normal ranges in the upper esophagus will be helpful in the interpretation of upper esophageal pH monitoring data.     

Prevalence,correlates of and perceptions toward cigarette smoking among adolescents in South Korea

Objective  To estimate the prevalence of current smoking, correlates of smoking and assess exposure to and perceptions towards smoking by gender. Methods  We used data from the South Korea Global Youth Tobacco Survey (GYTS). Frequencies of selected characteristics and their 95% confidence were obtained. Current cigarette smoking was defined as having smoked, even a single puff, within the last 30 days. Logistic regression analysis was conducted to assess the factors that were considered to be associated with current cigarette smoking in bivariate and multivariate analyses. Results  Of the 5615 respondents, 7.4% males and 5.0% females reported being current smokers (p = 0.003). Having smoking friends was strongly associated with smoking after controlling for age, gender, parental smoking status, exposure to anti-smoking media messages, and perception of risks of smoking (OR=69.92; 95% CI [41.24, 118.57] for most friends and OR=11.86; 95% CI [7.26, 19.36] for some friends). Male gender and having one or both smoking parents were associated with smoking (OR=1.43; 95% CI [1.09, 1.89] and OR=1.29; 95% CI [1.00-, 1.71] respectively). Exposure to antismoking media messages was negatively associated with smoking (OR=0.52; 95% CI [0.36, 0.77]. Conclusion  Prevalence of smoking among adolescents in South Korea is lower than in many other Asian countries. There is however, need to strengthen anti-tobacco messages especially among adolescents.     

Growing pains: Practitioners’ dilemma

Need and Purpose of Review

Though cases of ‘growing pains’ are quite common in pediatric practice, very little attention has been given to it, even in the standard text books. The resultant confusion among practitioners regarding diagnosis and management of this condition needs to be addressed.

Methods used for locating, selecting, extracting and synthesizing data

PubMed search was performed using “growing pains “[All Fields] AND ((“child”[MeSH Terms] OR “child”[All Fields] OR “children”[All Fields]) AND (“pediatrics”[MeSH Terms] OR “pediatrics”[All Fields] OR “pediatric”[All Fields])). Types of articles included are Review articles, Systemic Reviews, Randomized Controlled Trials, Practice guidelines and Observational studies. Google Scholar was also searched using the term “Growing pains in children”. Relevant articles not included in the PubMed results were selected. Reference lists of selected studies were also screened to identify additional studies.

Main conclusions

A fairly accurate diagnosis of ‘growing pains’ can be made clinically, if the widely accepted diagnostic criteria are followed. A systematic approach, with due consideration of both inclusion as well as exclusion criteria, can avoid unnecessary (sometimes potentially harmful) investigations and medications. Reassurance remains the main stay in the management of ‘growing pains’.     

PPAR-gamma2 Pro12Ala variant, insulin resistance and plasma long-chain polyunsaturated fatty acids in childhood obesity

Pro12Ala variant of peroxisome-proliferator-activated receptor-gamma2 (PPAR-gamma2) may be linked to insulin sensitivity. This study examined whether an association of PPAR-gamma2 Pro12Ala with insulin resistance and plasma LCPUFAs may exist in obese children. One hundred and forty Italian normolipidemic obese children (58 girls and 82 boys, mean age [SD], 10.2 [2.7] y) entered the study. Obesity was defined according to International Obesity Task Force. BMI Z-scores were calculated. Fasting blood glucose, insulin, lipids and plasma fatty acids were measured. Insulin resistance was estimated by the homeostatic model assessment (HOMA-IR). The frequency of Ala allele was 9%. Mean [SD] values of fasting insulin and HOMA-IR in Pro/Pro versus Pro12Ala groups were: 19.3 [10.6] versus 14.1 [10.4] microU/mL (p = 0.017) and 4.2 [2.3] versus 3.0 [2.3] (p = 0.022). Mean [SD] values of plasma C20:3n-9 and of C20:4n-6, C20:5n-3, C22:6n-3 and n-6/n-3 LCPUFA in phospholipds in Pro/Pro versus Pro12Ala groups were: 0.15 [0.07] versus 0.12 [0.08] % (p = 0.014), 8.9 [1.9] versus 10.2 [2.6] % (p = 0.023), 0.34 [0.15] versus 0.42 [0.11] % (p = 0.005), 2.1 [0.9] versus 2.6 [0.9] % (p = 0.032) and 4.8 [1.2] versus 4.2 [0.7] (p = 0.017). Pro12Ala may be associated with higher insulin sensitivity and higher LCPUFAs, particularly n-3, levels in plasma phosholipids of obese children.     

Blood lactate disappearance dynamics in boys and men following exercise of similar and dissimilar peak-lactate concentrations

Characteristically, children recover faster than adults from various types of exercise. The purpose of the present study was to explain the children's faster recovery, in part, by addressing lactate (La) removal and comparing La disappearance dynamics in the two age groups following exercise of both similar and dissimilar peak blood-lactate concentration values ([La]pk). The subjects were 14 prepubertal boys and 12 men of similar peak oxygen consumption, normalized for body mass. All subjects performed 30 s supra-maximal cycling (Wingate anaerobic test [WAnT]). [La]pk was 10.7 +/- 1.9 and 14.7 +/- 1.7 mmol x l(-1) for the boys and men, respectively (p < 0.001). The men were later retested in shortened versions of the WAnT so as to attain [La]pk values (10.5 +/- 0.7 mmol x l(-1)) comparable to those achieved by the boys. [La]pk lag time following the boys' standard WAnT was similar to that found in the men following the shortened WAnT (5.0 +/- 2.6 vs 5.7 +/- 1.3 min, respectively), but considerably shorter than that following the men's 30s-WAnT (7.6 +/- 2.1 min; p < 0.05). The La disappearance dynamics were closely matched between groups following the matched [La]pk WAnTs. [La] half-life was similar under all conditions (ca. 20 min). It is concluded that prepubertal boys are characterized by a lower [La]pk and a shorter time lag before reaching it, following 30-s supra-maximal cycling exercise. However, boys' La disappearance dynamics are not different from that of men.     

Disparities in Maternal-Infant Drug Testing,Social Work Assessment,and Custody at 5 Hospitals

ObjectiveTo evaluate for disparities in peripartum toxicology testing among maternal-infant dyads across a hospital network and subsequent child protective services (CPS) involvement.MethodsRetrospective chart review of 59,425 deliveries at 5 hospitals in Massachusetts between 2016 and 2020. We evaluated associations between maternal characteristics, toxicology testing, and child welfare involvement with disproportionality risk ratios and hierarchical logistical regression.ResultsToxicology testing was performed on 1959 (3.3%) dyads. Younger individuals and individuals of color were more likely to be tested for cannabis use or maternal medical complications compared to white non-Hispanic individuals. Among those without a substance use disorder, age <25 (adjusted odds ratio [aOR] 2.81; 95% confidence interval [CI], 2.43–3.26), race and ethnicity (non-Hispanic Black (aOR 1.80; 95% CI, 1.52–2.13), Hispanic (aOR 1.23; 95% CI, 1.05–1.45), mixed race/other (aOR 1.40; 95% CI, 1.04, 1.87), unavailable race (aOR 1.92; 95% CI, 1.32–2.79), and public insurance (Medicaid [aOR 2.61; 95% CI, 2.27–3.00], Medicare [aOR 13.76; 95% CI, 9.99–18.91]) had increased odds of toxicology testing compared to older, white non-Hispanic, and privately insured individuals. The disproportionality ratios in testing were greater than 1.0 for individuals under 25 years old (3.8), Hispanic individuals (1.6), non-Hispanic Black individuals (1.8), individuals of other race (1.2), unavailable race (1.8), and individuals with public insurance (Medicaid 2.6; Medicare 10.6). Among dyads tested, race and ethnicity was not associated with CPS involvement.ConclusionsPeripartum toxicology testing is disproportionately performed on non-white, younger, and poorer individuals and their infants, with cannabis use and medical complications prompting testing more often for patients of color than for white non-Hispanic individuals.