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1.
Objective
To measure physical activity in children with wasting and to look for association between poor physical activity and wasting.Methods
Physical activity was measured in 56 children with wasting, using Children’s Activity Rating Scale, and compared with age- and sex-matched controls.Results
A significant association was found between poor physical activity and malnutrition as determined by weight-for-height Z Score <-2 (P=0.001) and midupper-arm circumference (P=0.002).Conclusion
Physical activity can be used as clinical parameter to assess malnutrition. 相似文献2.
Lorna P. Browne Debra Kearney Michael D. Taylor Taylor Chung Timothy C. Slesnick Arni C. Nutting Rajesh Krishnamurthy 《Pediatric radiology》2010,40(2):163-167
Background
ALCAPA is optimally treated by coronary artery reimplantation early in neonatal life. Delayed diagnosis, however, is not infrequent, because symptoms often do not manifest until about 3 months of age, coinciding with the physiological nadir in pulmonary vascular resistance. With delayed diagnosis, there is potential for coronary steal and irreversible myocardial injury, which worsens outcome. 相似文献3.
Mohammad-Hassan Moradinejad Amir Rezaei Vahid Ziaee 《Iranian journal of pediatrics.》2011,21(4):530-534
Background
Churg-Strauss syndrome (CSS), a systemic vasculitis accompanied by asthma and eosinophilia, almost invariably affects the lung and is frequently associated with cutaneous involvement. It rarely has cardiac involvement. We report an unusual case of CSS with myocardial involvement and stroke.Case Presentation
A 16-year old female suffered of allergic asthma for 4 years. She was under treatment with oral prednisolone and seretide inhalation. After CSS diagnosis, she developed paroxysmal atrial tachycardia. Serum levels of Troponin I and Troponin T were increased indicating massive myocardial damage probably due to myocarditis. After 5 months she developed acute hemiparesis without any evidence of ischemic or hemorrhagic event. She was treated with IVIg, intravenous pulses of methylprednisone and cyclophosphamide for each complication.Conclusion
Myocarditis and stroke may also complicate CSS which should be taken in consideration for better management. 相似文献4.
Susy Joseph Sobha Kumar Zulfikar Ahamed M S. Lakshmi 《Indian journal of pediatrics》2018,85(10):877-884
Objectives
To describe the diagnostic test properties of Cardiac Troponin-T (cTnT) in predicting myocardial dysfunction in asphyxiated term neonates by taking echocardiography as the gold standard and to establish the optimum cut-off values of cTnT for myocardial dysfunction, shock, severe hypoxic ischemic encephalopathy (HIE) and mortality by receiver operator characteristic (ROC) curve analysis.Methods
This was a prospective study based on diagnostic test evaluation. The study included 120 term asphyxiated neonates in a tertiary care neonatal intensive care unit (NICU) in Southern India from June 2011 through June 2015. All the neonates were clinically evaluated. Venous blood was taken at 4 h of life for cTnT estimation. Echocardiography was done within 24 h of birth.Results
The mean cTnT level of asphyxiated term neonates was 0.207±0.289 ng/ml (mean ± SD). Asphyxiated neonates with myocardial dysfunction had higher cTnT levels (0.277±0.231) as compared to those without myocardial dysfunction (0.061±0.036, p?=?0.0001). Using ROC curve, the cut-off cTnT values for myocardial dysfunction was 0.1145 ng/ml with sensitivity 92.4% and specificity 94.1%. Cardiac Troponin-T levels were significantly higher among asphyxiated neonates with shock (0.378±0.348, p?=?0.0001) and the levels also correlated positively with increasing grades of HIE. The cut-off cTnT value for mortality was 0.2505 ng/ml with sensitivity 83.9% and specificity 96.6%.Conclusions
In asphyxiated term neonates, early cTnT elevation is a marker for predicting myocardial dysfunction and elevated cTnT levels had high sensitivity and specificity. There was significant relation with increasing cTnT values and increasing grades of HIE.5.
Kristin Garton Crichton Jennifer N. Cooper Peter C. Minneci Jonathan I. Groner Jonathan D. Thackeray Katherine J. Deans 《Pediatric surgery international》2016,32(8):815-818
Purpose
Recognition of physical child abuse is imperative for ensuring children’s safety. Screening tools (ST) may increase identification of physical abuse; however, the extent of their use is unknown. This study assessed use of STs for physical abuse in children’s hospitals and determined attitudes regarding STs.Methods
A web-based survey was sent to child abuse program contacts at 103 children’s hospitals. The survey assessed institutional use of a ST for physical abuse and characteristics of the ST used. Respondents were asked to identify benefits and liabilities of STs used or barriers to ST use.Results
Seventy-two respondents (70 %) completed the survey; most (64 %) were child abuse pediatricians. Nine (13 %) respondents reported using a ST for physical abuse; STs varied in length, population, administration, and outcomes of a positive screen. Most respondents (86 %) using a ST felt that it increased detection of abuse. Barriers noted included lack of time for development and provider completion of a ST.Conclusions
While few respondents endorsed use of a ST for physical abuse, most believed that it increased detection of abuse. Future research should focus on development of a brief, uniform ST for physical abuse which may increase detection in at-risk children.6.
Asadolah Tanasan Armen Kocharian Keyhan Sayadpour Zanjani Farah K. Payravian Sadat Torabian 《Iranian journal of pediatrics.》2013,23(5):593-596
Objective
Despite progresses in surgical correction of Tetralogy of Fallot, pulmonary insufficiency and progressive dysfunction of the right ventricle impress its long-term prognosis. In this study we examined the correlations between QRS duration, pulmonary insufficiency and right ventricular performance index.Methods
We enrolled 57 repaired Tetralogy of Fallot patients. QRS duration on electrocardiogram, pulmonary regurgitation index (regurgitation time to diastolic time ratio), and right ventricular myocardial performance index were measured.Findings
There was a strong inverse correlation between QRS duration and pulmonary regurgitation index. However, significant correlation did not exist between QRS duration and right ventricular myocardial performance index. QRS duration ≥160 ms predicted severe pulmonary regurgitation with 100% sensitivity and 87% specificity.Conclusion
Increased QRS duration can predict severity of pulmonary regurgitation. 相似文献7.
Objective
To quantify myocardial iron stores by Cardiac Magnetic Resonance (CMR). 相似文献8.
Kelly LA Reilly JJ Fisher A Montgomery C Williamson A McColl JH Paton JY Grant S 《Archives of disease in childhood》2006,91(1):35-38
Background
A socioeconomic gradient in childhood obesity is known to be present by the age of school entry in the UK. The origin of this gradient is unclear at present, but must lie in socioeconomic differences in habitual physical activity, sedentary behaviour, or dietary intake.Aims
To test the hypothesis that habitual physical activity and/or sedentary behaviour are associated with socioeconomic status (SES) in young Scottish children.Methods
Observational study of 339 children (mean age 4.2 years, SD 0.3) in which habitual physical activity and sedentary behaviour were measured by accelerometry over six days (study 1). In a second study, 39 pairs of children of distinctly different SES (mean age 5.6 years, SD 0.3) were tested for differences in habitual physical activity and sedentary behaviour by accelerometry over seven days.Results
In study 1, SES was not a significant factor in explaining the amount of time spent in physical activity or sedentary behaviour once gender and month of measurement were taken into account. In study 2, there were no significant differences in time spent in physical activity or sedentary behaviour between affluent and deprived groups.Conclusion
Results do not support the hypothesis that low SES in young Scottish children is associated with lower habitual physical activity or higher engagement in sedentary behaviour. 相似文献9.
Background
The accurate evaluation of physical activity levels amongst youth is critical for quantifying physical activity behaviors and evaluating the effect of physical activity interventions. The purpose of this review is to evaluate contemporary approaches to physical activity evaluation amongst youth.Data sources
The literature from a range of sources was reviewed and synthesized to provide an overview of contemporary approaches for measuring youth physical activity.Results
Five broad categories are described: selfreport, instrumental movement detection, biological approaches, direct observation, and combined methods. Emerging technologies and priorities for future research are also identified.Conclusions
There will always be a trade-off between accuracy and available resources when choosing the best approach for measuring physical activity amongst youth. Unfortunately, cost and logistical challenges may prohibit the use of ??gold standard?? physical activity measurement approaches such as doubly labelled water. Other objective methods such as heart rate monitoring, accelerometry, pedometry, indirect calorimetry, or a combination of measures have the potential to better capture the duration and intensity of physical activity, while self-reported measures are useful for capturing the type and context of activity. 相似文献10.
Ahmad Ghamei Khosroshahi Keyhan Sayadpour Zanjani Armen Kocharian Aliakbar Zeinaloo Abdolrazagh Kiani Elaheh Malakan Rad 《Iranian journal of pediatrics.》2013,23(5):519-524
Objective
Although there are several echocardiographic criteria, there is not yet a general consensus about the diagnosis of left ventricular noncompaction. The current criteria are mostly based on the areas with maximal noncompaction in the heart. The echocardiographer may miss this maximal point leading to a misdiagnosis. Accordingly, we suggested a new method to measure the percentage of myocardial noncompaction using two-dimensional echocardiography.Methods
In this study, the new method was examined on 4 noncompaction and 26 dilated cardiomyopathies, and 25 normal subjects. The percentage of noncompaction was measured at 3 levels (apical, papillary muscle and mitral valve) and averaged.Findings
The mean percentages of myocardial noncompaction were 3.59±2.27, 8.86±5.52 and 34.7±26.1 in the control, dilated cardiomyopathy and noncompaction groups, respectively. A value of 17% or greater could distinguish left ventricular noncompaction from dilated cardiomyopathy with 92% specificity and 100% sensitivity and from normal subjects with 100% specificity and sensitivity. This percentage had a statistically significant association with noncompacted to compacted myocardial thickness ratio (P<0.001).Conclusion
This method showed good correlations with the existing echocardiographic and magnetic resonance criteria. However, it is not dependent on finding the area of maximal involvement. Being comparable to magnetic resonance imaging in accuracy, it is easier to perform and more available. 相似文献11.
McCrindle BW Williams RV Mital S Clark BJ Russell JL Klein G Eisenmann JC 《Archives of disease in childhood》2007,92(6):509-514
Objectives
To determine physical activity levels in paediatric patients who underwent the Fontan procedure, and their relationship to functional status and exercise capacity.Study Design
We studied 147 patients (ages 7–18 years) at a median of 8.1 years after Fontan, as part of the Pediatric Heart Network cross‐sectional study of Fontan survivors. Assessment included medical history, self‐reported physical activity, parent‐completed Child Health Questionnaire (CHQ), cardiopulmonary exercise testing and physical activity level measured by accelerometry (MTI Actigraph).Results
Measured time spent in moderate and vigorous activity was markedly below normal at all ages, particularly in females, and was not significantly related to self‐reported activity levels, or to maximum Vo2, Vo2 at anaerobic threshold or maximum work rate on exercise testing. Lower measured activity levels were significantly related to lower perceived general health but not to self‐esteem, physical functioning, social impact of physical limitations or overall physical or psychosocial health summary scores. Reduced exercise capacity was more strongly related than measured activity levels to lower scores in general health, self‐esteem and physical functioning.Conclusions
Physical activity levels are reduced after Fontan, independent of exercise capacity, and are associated with lower perceived general health but not other aspects of functional status. 相似文献12.
Muhammad Shahid Hussain Saleemi Afif El-Khuffash Orla Franklin John David Corcoran 《Early human development》2014
Background
Myocardial performance is impaired in the first days of life in preterm infants but improves by day 5. Tissue Doppler imaging (TDI) is a novel and reliable means of assessing myocardial performance.Objective
To investigate myocardial performance using TDI and shortening fraction (SF) in preterm infants of different gestational age groups and serial changes in these parameters in first four weeks of life.Study designInfants less than 36 weeks of gestation were divided into group 1 (24–27 weeks, n = 8), group 2 (28–31 weeks, n = 12) and group 3 (32–35 weeks, n = 13). Infants with severe congenital malformations, a hypoxic insult at birth, and those on inotropic support were excluded. Echocardiograms were performed at 36–48 hours, 2 weeks and 4 weeks of life. Left ventricular (LV) SF, systolic (S′), early diastolic (E′) and late diastolic (A′) TDI velocities were assessed. We analyzed the data using a repeated-measures ANOVA.Results
Thirty three infants underwent serial TDI and SF measurements. There was an increase in LV S′ (p = .02) and E′ (.01) velocities in group 2 , and in group 3 (p = .03 for S′ and p = .04 for E′), but no significant increase in group 1 (p = .48 for S′ and .32 for E′). At each study point, there was significant difference in myocardial performance between group 1 and 3 for each of the parameters (p < .05). There was no significant increase in SF over time in any of the groups.Conclusion
We describe a serial increase in myocardial performance in infants of 28 weeks gestation and above. While there was no change in myocardial performance among the most extremely preterm infants, this may have been the result of small sample size of the group. 相似文献13.
Background
The postnatal period in preterm infants involves multiple physiologic changes starting directly after birth and continuing for days or weeks. To recognize and treat compromise, it is important to measure cardiovascular function. We used a novel technique (speckle tracking echocardiography, STE) to measure cardiac function in this period.Methods
We obtained cardiac ultrasound images at day 3, 7, 14, 21 and 28 in preterm infants <30-week gestation. Conventional measures included cardiac size, left ventricular stroke volume, atrial volume and the patent ductus arteriosus (PDA). Four chamber images were analyzed with STE, which provided parameters of left ventricular volume, longitudinal deformation and myocardial velocities.Results
Images of 54 infants (gestational age 23–29 weeks) were analyzed. STE-derived stroke volume correlated well with conventional echocardiography-derived stroke volume, but agreement was suboptimal. Most STE parameters showed good reliability. All volume parameters and systolic and atrial velocities increased over time. Cardiac deformation and early diastolic velocity did not change. A PDA was associated with 33 % increased stroke volume at day 3 up to 98 % at day 28 with a spherically enlarged heart and increased filling pressure.Conclusion
Speckle tracking echocardiography analysis is a feasible and reliable technique that can simultaneously obtain systolic and diastolic volumes, longitudinal deformation and myocardial velocities from one ultrasound window. Preterm hearts maintain cardiac function well during the first weeks of life, even with increased preload as a consequence of a PDA.14.
BACKGROUND
With an increasing population of childhood cancer survivors and a growing recognition of the long-term effects of diagnosis and treatment, it is imperative that modifiable risk factors for long-term health and disease comorbidity be identified and addressed. Physical activity is one therapy that is gaining credibility in enhancing quality of life and reducing the burden of disease.OBJECTIVES
To examine the beliefs, attitudes and counselling practices of a group of Alberta-based paediatric oncologists.METHODS
All Alberta-based physicians with a known specialty in paediatric oncology were approached and asked to complete a onetime, mail-out survey.RESULTS
All responding physicians regarded both personal exercise and physical activity for childhood cancer survivors as moderately to extremely important. Importantly, one-half of the respondents believed that there is no adverse risk associated with physical activity in this survivor group. While the bulk of physicians report prescribing physical activity, few believe that their patients actually follow these recommendations.CONCLUSIONS
Responding oncologists acknowledge the importance of physical activity for all survivors; however, future research is needed to better understand how to best promote healthy active living within this group. 相似文献15.
André O. Werneck Danilo R. Silva Paul J. Collings Rômulo A. Fernandes Enio R.V. Ronque Manuel J. Coelho-e-Silva Luís B. Sardinha Edilson S. Cyrino 《Jornal de pediatria》2018,94(6):658-665
Objective
To test the biocultural model through direct and indirect associations between biological maturation, adiposity, cardiorespiratory fitness, feelings of sadness, social relationships, and physical activity in adolescents.Methods
This was a cross-sectional study conducted with 1,152 Brazilian adolescents aged between 10 and 17 years. Somatic maturation was estimated through Mirwald's method (peak height velocity). Physical activity was assessed through Baecke questionnaire (occupational, leisure, and sport contexts). Body mass index, body fat (sum of skinfolds), cardiorespiratory fitness (20-m shuttle run test), self-perceptions of social relationship, and frequency of sadness feelings were obtained for statistical modeling.Results
Somatic maturation is directly related to sport practice and leisure time physical activity only among girls (β = 0.12, p < 0.05 and β = 0.09, respectively, p < 0.05). Moreover, biological (adiposity and cardiorespiratory fitness), psychological (sadness), and social (satisfaction with social relationships) variables mediated the association between maturity and physical activity in boys and for occupational physical activity in girls. In general, models presented good fit coefficients.Conclusion
Biocultural model presents good fit and emotional/biological factors mediate part of the relationship between somatic maturation and physical activity. 相似文献16.
17.
Hiba Abujaradeh Reema Safadi Susan M. Sereika Cecilia T. Kahle Susan M. Cohen 《Journal of pediatric health care》2018,32(5):455-472
Introduction
We aimed to determine the benefits/efficacy of mindfulness-based interventions (MBIs) implemented among adolescents with chronic diseases in clinical settings.Methods
An electronic search of PubMed, CINAHL, and PsycINFO databases was conducted in November 2017 to identify studies in which mindfulness was the primary intervention delivered for adolescents with chronic diseases to improve psychological and physical health.Results
Nineteen eligible studies were included in this review. Fifteen studies included adolescents with psychiatric or pain disorders, and four included adolescents with a chronic physical disorders. Psychological outcomes and pain were examined in most studies with effect sizes for MBIs ranging from small to large.Discussion
MBI studies conducted in clinical settings mainly engaged adolescents with psychiatric or pain disorders. The effectiveness of MBIs on improving psychological outcomes were inconsistent. Large randomized trials are needed to examine the effectiveness of MBIs and should expand to include adolescents with chronic physical diseases. 相似文献18.
Eirik Nestaas Janne Helen Skranes Asbjørn Støylen Leif Brunvand Drude Fugelseth 《Early human development》2014
Background
Therapeutic hypothermia has become standard treatment for moderate and severe neonatal hypoxic–ischemic encephalopathy (HIE) to reduce cerebral morbidity and mortality. The effect on the heart is incompletely explored.Aim
To assess the myocardial function during and after whole-body therapeutic hypothermia for HIE.Study design
Observational cohort study.Subjects
Forty-four infants with HIE cooled for 72 hours were compared with 48 healthy term infants and 20 normothermic infants with HIE.Outcome measures
Tissue Doppler deformation indices of myocardial function (peak systolic strain, peak systolic strain-rate, early diastole strain-rate and strain-rate in atrial systole) during (days 1 and 3) and after (day 4) therapeutic hypothermia.Results
On days one and three all indices in both HIE groups were lower than the corresponding indices in the healthy infants. The two HIE groups had similar indices, except peak systolic strain-rate on days 1 and 3 and strain-rate in atrial systole on day 1. All strain-rate indices improved from day 3 to 4 (after rewarming) in the cooled group and achieved similar values to those in healthy infants on day 3. All indices were higher in the cooling-group after rewarming than in the normothermic infants with HIE on day 3, except early diastolic strain-rate.Conclusions
Infants with HIE had similarly impaired myocardial function during days 1–3 whether normothermic or hypothermic. The myocardial function improved significantly at day 4 (after rewarming), approaching the day 3 levels in the healthy neonates. 相似文献19.
The contribution of physical fitness to individual and ethnic differences in risk markers for type 2 diabetes in children: The Child Heart and Health Study in England (CHASE)
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Claire M Nightingale Alicja R Rudnicka Sarah R Kerry‐Barnard Angela S Donin Soren Brage Kate L Westgate Ulf Ekelund Derek G Cook Christopher G Owen Peter H Whincup 《Pediatric diabetes》2018,19(4):603-610
Background
The relationship between physical fitness and risk markers for type 2 diabetes (T2D) in children and the contribution to ethnic differences in these risk markers have been little studied. We examined associations between physical fitness and early risk markers for T2D and cardiovascular disease in 9‐ to 10‐year‐old UK children.Methods
Cross‐sectional study of 1445 9‐ to 10‐year‐old UK children of South Asian, black African‐Caribbean and white European origin. A fasting blood sample was used for measurement of insulin, glucose (from which homeostasis model assessment [HOMA]‐insulin resistance [IR] was derived), glycated hemoglobin (HbA1c), urate, C‐reactive protein (CRP), and lipids. Measurements of blood pressure (BP) and fat mass index (FMI) were made; physical activity was measured by accelerometry. Estimated VO2 max was derived from a submaximal fitness step test. Associations were estimated using multilevel linear regression.Results
Higher VO2 max was associated with lower FMI, insulin, HOMA‐IR, HbA1c, glucose, urate, CRP, triglycerides, LDL‐cholesterol, BP and higher HDL‐cholesterol. Associations were reduced by adjustment for FMI, but those for insulin, HOMA‐IR, glucose, urate, CRP, triglycerides and BP remained statistically significant. Higher levels of insulin and HOMA‐IR in South Asian children were partially explained by lower levels of VO2max compared to white Europeans, accounting for 11% of the difference.Conclusions
Physical fitness is associated with risk markers for T2D and CVD in children, which persist after adjustment for adiposity. Higher levels of IR in South Asians are partially explained by lower physical fitness levels compared to white Europeans. Improving physical fitness may provide scope for reducing risks of T2D. 相似文献20.
Mohammad-Nasir Hematian Shirin Torabi Elaheh MalaKan-Rad Keyhan Sayadpour-Zanjani Vahid Ziaee Masoumeh Lotfi-Tolkaldany 《Iranian journal of pediatrics.》2015,25(3)