190 research outputs found
Torcicollo A Tuttalè! (Note) Coccolini, E.a, Bruzzi, P.b, Bergonzini, P.b, Iughetti, L.ab
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Obesity and craniopharyngioma.
Get PDFAn epidemic of pediatric obesity has occurred across the world in recent years. There are subgroups within the population at high-risk of becoming obese and especially of having experience of precocious cardiovascular and metabolic co-morbidities of obesity. One of these subgroups comprises patients treated for childhood cancers and namely survivors of craniopharyngioma. The high incidence of obesity in this group makes these patients an important disease model to better understand the metabolic disturbances and the mechanisms of weight gain among cancer survivors. The hypothalamic-pituitary axis damage secondary to cancer therapies or to primary tumor location affect long-term outcomes. Nevertheless, the aetiology of obesity in craniopharyngioma is not yet fully understood. The present review has the aim of summarizing the published data and examining the most accepted mechanisms and main predisposing factors related to weight gain in this particular population
Novel insights on the treatment of hypercholesterolemia
Get PDFThe diagnosis of dyslipidemia is increasing both in adulthood and in childhood because of not only the steadily increasing prevalence of obesity but also a rise of medical attention in detecting unfavorable genetic conditions in patients of all ages. Attempts in lifestyle changes are frequently failing and thus the pharmacological treatment of dyslipidemia is spreading in medical practice to reduce cardiovascular risk. In childhood, statins are authorized by 8 years of age. Nevertheless, data on their long-term safety and efficacy are still lacking, especially in ones with high cardiovascular risk and/or primary dyslipidemia such as homozygous familial hypercholesterolemia, considerable as a mainly exclusively pediatric disease. Thus, new pharmacological approaches are needed and have to be evaluated in all categories of patients. In this context, the update and the critical revision of new medications have become a new duty for scientists and clinicians
Le dislipidemie in età evolutiva: quale approccio
No full textLa prevenzione delle patologie cardiovascolari deve iniziare
già in età pediatrica: la definizione dei parametri lipidici
e di strategie di screening condivise, nonché un corretto
ricorso alla terapia dietetica e farmacologica, rappresentano
presupposti irrinunciabili per migliorare la gestione
del bambino dislipidemico
Approaches to dyslipidemia treatment in children and adolescents
No full textAtherosclerosis represents a disease that begins in childhood, and alterations in lipid concentration play a fundamental role in the development of this condition. Children and adolescents with high cholesterol levels are more likely than their peers in the general population to present with dyslipidemia in adulthood. Precocious identification of dyslipidemias associated with premature cardiovascular disease is crucial during childhood to delay or prevent the atherosclerotic process. The National Cholesterol Education Program has established guidelines for the diagnosis and treatment of dyslipidemia during pediatric age. It has been suggested that a heart-healthy diet should begin at 2 years of age, and no adverse effects on psychological aspects, growth, pubertal development and nutritional status in children and adolescents limiting total and saturated fat intake have been demonstrated. Pharmacotherapy should be considered in children aged 10 years or older when low-density lipoprotein cholesterol concentrations remain very high despite dietary therapy, especially when multiple risk factors are present. The lipid-lowering drugs recommended for childhood and adolescence are resins and statins. The increasing use of statins is dependent on their effectiveness and safety. Ezetimibe, a selective cholesterol absorption inhibitor, may provide a similar cholesterol-lowering effect as that reached with statin treatment. This review provides an update on recent advances in the therapy of dyslipidemia, especially hypercholesterolemia, during pediatric age and adolescence
Obesity in patients with acute lymphoblastic leukemia in childhood
Get PDFAbstract Acute lymphoblastic leukemia is the most common malignancy in childhood. Continuous progress in risk-adapted treatment for childhood acute lymphoblastic leukemia has secured 5-year event-free survival rates of approximately 80% and 8-year survival rates approaching 90%. Almost 75% of survivors, however, have a chronic health condition negatively impacting on cardiovascular morbidity and mortality. Obesity can be considered one of the most important health chronic conditions in the general population, with an increasing incidence in patients treated for childhood cancers and especially in acute lymphoblastic leukemia survivors who are, at the same time, more at risk of experiencing precocious cardiovascular and metabolic co-morbidities. The hypothalamic-pituitary axis damage secondary to cancer therapies (cranial irradiation and chemotherapy) or to primary tumor together with lifestyle modifications and genetic factors could affect long-term outcomes. Nevertheless, the etiology of obesity in acute lymphoblastic leukemia is not yet fully understood. The present review has the aim of summarizing the published data and examining the most accepted mechanisms and main predisposing factors related to weight gain in this particular population.</p
Hypercholesterolemia in Childhood
No full textThe American Heart Association (AHA), endorsed by the American Academy of Pediatrics (AAP), identified 8 high-risk pediatric diagnosis and developed practical recommendations for the management of cardiovascular risk.. The selected diseases comprise familial hypercholesterolemia (FH), together with diabetes mellitus (type 1 and 2), chronic kidney disease, heart transplantation, Kawasaki disease, congenital heart disease, chronic inflammatory disease and childhood cancer. Subclinical endothelia dysfunction, measured through non-invasive surrogate methods such as flow-mediated dilation (FMD), occurs early in FH children indicating an increased risk for premature CVD and reflecting the need for early initiation of anticholesterolemic treatment. Moreover, increasing evidences indicate that, in high-risk conditions as well as in most children with a minor degree of vascular involvement, appropriate therapy could prevent and/or reverse the progression of these cardiovascular changes]. Therefore, the identification and the management of hypercholesterolemia in children are of great consequence
Obesity in adolescence: Its prevention and psycho-social aspects [Prevenzione e aspetti psico-sociali dell'obesità in età evolutiva]
No full textObesity is the most frequent nutritional disorder in adolescence and the rapid rise in its prevalence is one of the most alarming public health issue that western countries have to face nowadays. Directly associated with the rise in adolescence obesity is an increase in the prevalence of weight-related medical problems such as type 2 diabetes and metabolic syndrome. Therefore, obese adolescents might even be the first generation to die before their parents. Interventions that target risk factors for obesity at the individual, family and community levels are needed in order to prevent its increasing prevalence. Being adolescence not only one of the most vulnerable periods for the development of obesity but also the most important formative period in life, youth is a priority population for intervention strategies on both food behaviour and physical activity
Efficacy, safety and tolerability of statin therapy in adolescents with familial hypercholesterolaemia
No full textA is efficient in improving lipid metabolism in FH children and adolescents. A familial history of premature CVD may influence the therapeutic compliance and let to the achievement of a better lipid profile. Side effects,
especially the increase of CPK levels, are frequent on ST, especially in males and independently from current pharmacological dose
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