Grown-up Kawasaki disease patients who have giant coronary aneurysms

Background  

Many Kawasaki disease (KD) patients have reached adulthood in Japan. The current status of adult patients who have giant coronary aneurysms with KD is not well understood.     

Developmental coordination disorder and cardiorespiratory fitness in children

It is not known whether children with Developmental Coordination Disorder (DCD) have lower cardiorespiratory fitness (CRF) than children without the disorder, or whether this relationship varies by age and gender. These issues are examined using a cross-sectional assessment of children 9-14 years of age (N = 549). Participants were screened for DCD using the short form Bruininks-Oseretsky Test of Motor Proficiency (BOTMP-SF). A BOTMP-SF age-adjusted standard score at or below the 10th percentile rank on the BOTMP-SF was required to classify a diagnosis for probable DCD. CRF was determined from each participant's predicted peak-aerobic power using the Léger 20-m shuttle-run test. Children with DCD report lower CRF than children without the disorder and are more likely to be in a high-risk group (相似文献   

Absence of interferon in sera of patients with Kawasaki syndrome.

We measured serum interferon concentrations in 42 patients with Kawasaki syndrome. The children ranged in age from 7 months to 6 years. All acute sera were obtained within 12 days of the onset of fever. Convalescent sera (illness day 19 to 56) were available from 25 of 42 patients. Sera were also obtained from 40 controls ranging in age from 2 months to 12 years. Control sera included healthy children (n = 14), children with bacterial infection (n = 10) and children with viral infection (n = 16). Sera were coded and interferon concentrations were measured blindly using human diploid fibroblast cell monolayers challenged with 10(4) plaque-forming units of vesicular stomatitis virus. Specimens from 10 of 16 patients with viral infection were positive for interferon. Three of 10 patients with bacterial infection had detectable serum interferon. No interferon was detected in specimens from the 14 healthy control children or the 42 children with Kawasaki syndrome. Despite the use of a sensitive assay we were unable to detect interferon in the sera of patients with Kawasaki syndrome.     

Complications of polycythemia in patients who have cyanotic congenital heart disease.

A 13-mo-old child is brought to his pediatrician following sudden onset of left-sided hemiplegia. The pediatrician accompanies the child and family to the emergency room. The pediatrician has been following the child, who has a diagnosis of possible cyanotic congenital heart disease. The child has never been known to have had a hypercyanotic episode. Oxygen saturation determinations by pulsed oximeter had been in the range of 84% to 88%. On one occasion, when the child was very upset, a reading of 78% was observed. At his 1-year visit, his hemoglobin level was 13 g/dL. On admission to the emergency department, a computed tomographic scan of the head was ordered. It demonstrated a right-sided nonhemorrhagic cerebrovascular lesion.     

Muscular strength and cardiorespiratory fitness is associated with higher insulin sensitivity in children and adolescents.

OBJECTIVE: To investigate the relationship of muscular strength and cardiorespiratory fitness (CRF) to insulin resistance. METHODS: In a cross sectional study of 126 volunteers (10-15 years) we measured insulin, glucose, lipids, body mass, height, waist circumference (WC), strength and CRF. Linear and logistic regression models assessed the relationships between these factors and estimated insulin resistance (Homeostasis Assessment Model2; HOMA2-IR). RESULTS: Greater insulin resistance was associated with greater adiposity, lower CRF, and strength. Upper body strength and WC were the only independent predictors of insulin resistance, accounting for 39% of the variance (p < 0.001). Children in the highest and middle tertiles of absolute upper body strength were 98% less likely to have high insulin resistance than those with the lowest strength, adjusted for maturation and central adiposity, body mass (OR = 0.019; p = 0.003). Similar trends were present for high vs. low CRF. CONCLUSION: Muscular strength has been identified for the first time as an independent and powerful predictor of better insulin sensitivity in children. Lower strength, CRF and higher central adiposity are highly predictive of higher levels of insulin resistance in this cohort, and should be considered potential targets for interventions designed to enhance metabolic fitness in children and adolescents.     

Physical activity, sports participation and aerobic fitness in children who have undergone surgery for congenital heart defects

Aim:  To investigate physical activity, sports participation and aerobic fitness in children who have undergone surgery for congenital heart defects.
Subjects and methods:  Children who had undergone surgery for congenital heart defects and healthy controls in the Gothenburg area were invited to participate in the study. All participants were aged 9–11 or 14–16 years. The activity monitor ActiReg was used to assess physical activity. Participants were interviewed about their participation in sports and performed a maximal exercise test on a bicycle with measured oxygen uptake.
Results:  A total of 32 and 25 patients, and 61 and 45 controls, in the two age-groups were included, respectively. The patients had a wide range of severity of congenital heart defects. The physical activity level was similar in the patients and the controls. The rate of sports participation was high for both patients and controls; 80–94% of all participants took part in sports at least once a week. The majority of the patients were considered to have at least a moderate level of aerobic fitness.
Conclusions:  Although children who have undergone surgery for congenital heart defects have a similar level of physical activity compared with that of healthy children, some of them may require support to participate in exercise and vigorous physical activity.     

Reduced physical activity level and cardiorespiratory fitness in children with chronic diseases

We aimed to compare physical activity level and cardiorespiratory fitness in children with different chronic diseases, such as type 1 diabetes mellitus (T1DM), obesity (OB) and juvenile idiopathic arthritis (JIA), with healthy controls (HC). We performed a cross-sectional study including 209 children: OB: n = 45, T1DM: n = 48, JIA: n = 31, and HC: n = 85. Physical activity level was assessed by accelerometer and cardiorespiratory fitness by a treadmill test. ANOVA, linear regressions and Pearson correlations were used. Children with chronic diseases had reduced total daily physical activity counts (T1DM 497 ± 54 cpm, p = 0.003; JIA 518 ± 28, p < 0.001, OB 590 ± 25, p = 0.003) and cardiorespiratory fitness (JIA 39.3 ± 1.7, p = 0.001, OB 41.7 ± 1.2, p = 0.020) compared to HC (668 ± 35 cpm; 45.3 ± 0.9 ml kg⁻¹ min⁻¹, respectively). Only 60.4% of HC, 51.6% of OB, 38.1% of JIA and 38.5% of T1DM children met the recommended daily 60 min of moderate-to-vigorous physical activity. Low cardiorespiratory fitness was associated with female gender and low daily PA. Conclusion: Children with chronic diseases had reduced physical activity and cardiorespiratory fitness. As the benefits of PA on health have been well demonstrated during growth, it should be encouraged in those children to prevent a reduction of cardiorespiratory fitness and the development of comorbidities.