1,721,006 research outputs found
The molecular basis for the link between maternal health and the origin of fetal congenital abnormalities: an overview of association with oxidative stress
Full text linkGrowth, Puberty, and Nutritional Disturbances
No full textOxidative stress can be defined as an imbalance between oxidant and antioxidant status, which occurs in physiological conditions. Of note, the alteration of the oxidant–antioxidant system may also influence the pathogenesis of many diseases. Recent data have clearly shown that oxidative stress plays an important role in the onset and progression of several pathologies even during childhood. The aim of this chapter is to summarize the most important and recent findings regarding the role of oxidative stress in growth, puberty, and nutrition. A careful analysis and critical interpretation of the literature data have been made in order to establish the correlation between the special needs of childhood and the impairment of oxidant–antioxidant system. Emerging evidences suggest that children affected by growth, puberty, as well as nutritional disturbances are highly exposed to oxidative stress. New clinical studies need to be performed to establish possible prophylactic actions or treatment protocols limiting the oxidative damage in childhood
Weight gain and insulin resistance in children treated with valproate: The influence of time
No full textThis study was undertaken in 2 parts to investigate the relationship between body size and insulin resistance during treatment with valproic acid in children. The cross-sectional part revealed differences in terms of body size and homeostasis model assessment of insulin resistance, which were higher in the group on medication. The longitudinal part showed a major increase in body size and insulin resistance during the first year of therapy. There was a subsequent decrease in insulin resistance in association with the rise of body size, however with a trend to level off. These results might be helpful to enhance the knowledge of valproic acid action on both insulin resistance and weight gain, allowing to plan appropriate approach for the prevention of the consequences of the treatment with valproic acid. © The Author(s) 2010
Editorial: New Insights in Diagnosing and Treatment of Glucose Disorders and Obesity in Children and Adolescents
Full text linkEditorial on the Research Topic New Insights in Diagnosing and Treatment of Glucose Disorders and Obesity in Children and Adolescent
Birth size, growth trajectory and later cardio-metabolic risk
Full text linkThere is increasing evidence of a strong association between intrauterine growth and subsequent development of chronic disease in adult life. Birth size and growth trajectory have been demonstrated to have an impact on cardio-metabolic health, both in childhood and adult life. Hence, careful observation of the children’s growth pattern, starting from the intrauterine period and the first years of life, should be emphasized to detect the possible onset of cardio-metabolic sequelae. This allows to intervene on them as soon as they are detected, first of all through lifestyle interventions, whose efficacy seems to be higher when they are started early. Recent papers suggest that prematurity may constitute an independent risk factor for the development of cardiovascular disease and metabolic syndrome, regardless of birth weight. The purpose of the present review is to examine and summarize the available knowledge about the dynamic association between intrauterine and postnatal growth and cardio-metabolic risk, from childhood to adulthood
Management of diabetic ketoacidosis in children and adolescents in sub-Saharan Africa: a review.
No full textBACKGROUND:
Diabetic ketoacidosis (DKA) is a complex metabolic state of hyperglycaemia, ketosis, and acidosis. Diabetes in sub-Saharan Africa is, in many patients a serious disease with a poor prognosis. Most deaths, however, are due to preventable causes.
OBJECTIVE:
To improve knowledge on the management of DKA in sub-Saharan Africa.
DATA SOURCES:
Literature review from different published sources.
DATA SYNTHESIS:
Health systems in sub-Saharan Africa are currently organised for the treatment of episodes of illness and not long-term conditions like diabetes. Therefore the high rates of DKA is essentially due to lack of training of health professionals, lack of facilities in most hospitals, lack of public awareness as well as lack of health education to individual patients/families. In addition erratic insulin supply coupling with infections, low parental education, poor insulin storage and lack of facilities for self monitoring of blood glucose.
CONCLUSION:
A complex unfavourable social and economic environment is the basis of the high prevalence of DKA in sub-Saharan Africa. Several episodes of DKA can be prevented by effective public awareness programmes and education to healthcare providers
Epidemiology and clinical outcomes in a multicentre regional cohort of patients with severe acquired brain injury
No full textPurpose: To evaluate epidemiological and clinical data on patients with severe acquired brain injury (sABI) admitted to rehabilitation units in the first 6 years since the inception of a regional register (2005–2010) in the Emilia-Romagna region (Italy). Method: Retrospective multicentre study of a regional cohort using data from an online regional register (GraviCerebrolesioni Emilia-Romagna – GRACER). The study included 318 patients who suffered sABI (defined by Glasgow Coma Scale score ≤8 recorded in the initial 24 h following injury), who were admitted to and subsequently discharged from rehabilitation units. Physical and cognitive functions were evaluated at admission and discharge. Other data recorded included aetiology, presence of secondary conditions and need for specific medical support. Results: Three-quarters of patients displayed improvements in physical and/or cognitive function at discharge from rehabilitation units, with 71.4% of patients returning home. Better outcomes at discharge were associated in particular with younger age, traumatic brain injury (versus non-traumatic), or absence of tracheostomy at admission. Conclusion: The GRACER register is a useful tool for the assessment of epidemiological and clinical information on sABI patients. In light of the positive impact on patient outcomes, rehabilitation in specialised units is highly encouraged and should occur as soon as possible.Implications for RehabilitationThere is a need for more epidemiological and clinical data associated with severe acquired brain injury, particular regarding those of non-traumatic origin.In a retrospective multicentre study of a regional cohort using data from an online regional register in Italy (GRACER), more than three-quarters of patients displayed improvements in physical and/or cognitive function at discharge from the rehabilitation units. Better outcomes at discharge were associated in particular with younger age, traumatic brain injury (versus non-traumatic) or absence of tracheostomy at admission.Admission to a specialised rehabilitation unit is highly encouraged for patients with severe acquired brain injury, and should occur as soon as possible.Policy-makers and service planners should continue to develop strategies and allocate adequate resources for rehabilitation services due to their positive impact on patient outcomes. In particular, patients with conditions associated with increased likelihood of poor outcomes may require special attention during rehabilitation to improve outcomes at discharge
Association between markers of endothelial dysfunction and early signs of renal dysfunction in pediatric obesity and type 1 diabetes
No full textBACKGROUND:
To evaluate whether circulating markers of endothelial dysfunction, such as intercellular adhesion molecule-1 (ICAM-1) and myeloperoxidase (MPO), are increased in youth with obesity and in those with type 1 diabetes (T1D) at similar levels, and whether their levels are associated with markers of renal function.
METHODS:
A total of 60 obese youth [M/F: 30/30, age: 12.5 ± 2.8 yr; body mass index (BMI) z-score: 2.26 ± 0.46], 30 with T1D (M/F: 15/15; age: 12.9 ± 2.4 yr; BMI z-score: 0.45 ± 0.77), and 30 healthy controls (M/F: 15/15, age: 12.4 ± 3.3 yr, BMI z-score: -0.25 ± 0.56) were recruited. Anthropometric measurements were assessed and a blood sample was collected to measure ICAM-1, MPO, creatinine, cystatin C and lipid levels. A 24-h urine collection was obtained for assessing albumin excretion rate (AER).
RESULTS:
Levels of ICAM-1 and MPO were significantly higher in obese [ICAM-1: 0.606 (0.460-1.033) μg/mL; MPO: 136.6 (69.7-220.8) ng/mL] and T1D children [ICAM-1: 0.729 (0.507-0.990) μg/mL; MPO: 139.5 (51.0-321.3) ng/mL] compared with control children [ICAM-1: 0.395 (0.272-0.596) μg/mL MPO: 41.3 (39.7-106.9) ng/mL], whereas no significant difference was found between T1D and obese children. BMI z-score was significantly associated with ICAM-1 (β = 0.21, p = 0.02) and MPO (β = 0.41, p < 0.001). A statistically significant association was also found between ICAM-1 and markers of renal function (AER: β = 0.21, p = 0.03; e-GFR: β = 0.19, p = 0.04), after adjusting for BMI.
CONCLUSIONS:
Obese children have increased markers of endothelial dysfunction and early signs of renal damage, similarly to children with T1D, confirming obesity to be a cardiovascular risk factor as T1D. The association between ICAM-1 with e-GFR and AER confirm the known the association between general endothelial and renal dysfunction
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