Nutritional status and its influencing factors in children with newly diagnosed inflammatory bowel disease / 中国当代儿科杂志

OBJECTIVES@#To investigate the nutritional status and its influencing factors in children with newly diagnosed inflammatory bowel disease (IBD).@*METHODS@#A retrospective analysis was conducted on the clinical data of children who were diagnosed with IBD for the first time in Hunan Children's Hospital from January 2015 to December 2021. Diagnostic delay was defined as the time from the symptom onset to IBD diagnosis being in the upper quartile (P76-P100) of all IBD children in the study. Multivariate logistic regression analysis was used to explore the risk factors for emaciation and growth retardation.@*RESULTS@#A total of 125 children with newly diagnosed IBD were included, with Crohn's disease being the main type (91.2%). The rates of emaciation and growth retardation were 42.4% (53 cases) and 7.2% (9 cases), respectively, and the rate of anemia was 77.6% (97 cases). Diagnostic delay was noted in 31 children (24.8%), with the time from the symptom onset to IBD diagnosis of 366 to 7 211 days. Multivariate logistic regression analysis showed that diagnostic delay was a risk factor for emaciation and growth retardation (OR=2.73 and OR=4.42, respectively; P<0.05) and that age was positively associated with emaciation (OR=1.30, P<0.05).@*CONCLUSIONS@#Children with newly diagnosed IBD have poor nutritional status, and the rates of anemia, emaciation, and growth retardation are high. Diagnostic delay is associated with malnutrition in children with IBD.

Growth of preterm low birth weight infants until 24 months corrected age: effect of maternal hypertension / Crescimento de prematuros de baixo peso até a idade de 24 meses corrigidos: efeito da hipertensão materna

OBJECTIVE: To evaluate the growth pattern of low birth weight preterm infants born to hypertensive mothers, the occurrence of growth disorders, and risk factors for inadequate growth at 24 months of corrected age (CA). METHODS: Cohort study of preterm low birth weight infants followed until 24 months CA, in a university hospital between January 2009 and December 2010. Inclusion criteria: gestational age < 37 weeks and birth weight of 1,500-2,499 g. Exclusion criteria: multiple pregnancies, major congenital anomalies, and loss to follow up in the 2nd year of life. The following were evaluated: weight, length, and BMI. Outcomes: growth failure and risk of overweight at 0, 12, and 24 months CA. Student's t-test, Repeated measures ANOVA (RM-ANOVA), and multiple logistic regression were used. RESULTS: A total of 80 preterm low birth weight infants born to hypertensive mothers and 101 born to normotensive mothers were studied. There was a higher risk of overweight in children of hypertensive mothers at 24 months; however, maternal hypertension was not a risk factor for inadequate growth. Logistic regression showed that being born small for gestational age and inadequate growth in the first 12 months of life were associated with poorer growth at 24 months. CONCLUSION: Preterm low birth weight born infants to hypertensive mothers have an increased risk of overweight at 24 months CA. Being born small for gestational age and inadequate growth in the 1st year of life are risk factors for growth disorders at 24 months CA. .

OBJETIVO: Avaliar o padrão de crescimento de prematuros de baixo peso nascidos de mães hipertensas, a ocorrência de distúrbios de crescimento e os fatores de risco para inadequado crescimento aos 24 meses de idade corrigida (IC). MÉTODOS: Estudo de coorte de prematuros de baixo peso acompanhados até 24 meses IC, em um hospital universitário, entre janeiro de 2009 e dezembro de 2010. Critérios de inclusão: idade gestacional < 37 semanas e peso de nascimento de 1500-2499 g. Excluídas: gestações múltiplas, anomalias congênitas maiores e perda de seguimento no segundo ano de vida. Foram avaliados: peso, comprimento e IMC. Desfechos: falha de crescimento e risco de sobrepeso com 0, 12 e 24 meses de IC. Teste t de Student, X2, Anova-RM e regressão logística múltipla foram usados. RESULTADOS: Foram estudados 80 prematuros de baixo peso nascidos de mães hipertensas e 101 de mães normotensas. Houve maior risco de sobrepeso em crianças de mães hipertensas aos 24 meses, entretanto a hipertensão materna não foi fator de risco para inadequado crescimento. A regressão logística mostrou que nascer pequeno para idade gestacional e ter inadequado crescimento nos primeiros 12 meses de vida associaram-se com pior crescimento aos 24 meses. CONCLUSÃO: Prematuros de baixo peso nascidos de mães hipertensas têm risco aumentado de sobrepeso aos 24 meses de IC. Ser pequeno para idade gestacional e ter inadequado crescimento no primeiro ano são fatores de risco para distúrbios no crescimento aos 24 meses de IC. .

Nutritional Status and Growth in Korean Children with Crohn's Disease: A Single-Center Study

BACKGROUND/AIMS: Malnutrition and growth retardation are important issues in treating pediatric Crohn's disease (CD). Thus, we aimed to investigate the prevalence of various nutritional and growth parameters at the time of diagnosis in Korean children with CD. METHODS: Seventy-one children (<18 years) were enrolled. We analyzed the Z-scores of height-for-age (HAZ), weight-for-height (WHZ), body mass index for age (BMIZ), bone mineral density for age (BMDZ), and the biochemical markers measured at the time of diagnosis. RESULTS: At diagnosis, HAZ <-2 was observed in three patients (4%), WHZ <-2 in 20 patients (28%), BMIZ <-2 in 19 patients (27%), and BMDZ <-2 in 11 patients (18%). The HAZ was significantly lower in females and patients with extraintestinal manifestations, and the WHZ and BMIZ were significantly lower in patients with stricturing and penetrating disease. Subnormal serum levels were highly prevalent for hemoglobin, albumin, iron, ferritin, calcium, magnesium, folate, vitamin B12, and zinc. There was a significant correlation between nutritional status, growth retardation, and disease activity. CONCLUSIONS: Abnormal nutritional status was highly prevalent in Korean children with CD at the time of diagnosis and was associated with the extent, behavior, and activity of the disease.

The First Korean Case of Lysinuric Protein Intolerance: Presented with Short Stature and Increased Somnolence

Lysinuric protein intolerance (LPI) is a rare inherited metabolic disease, caused by defective transport of dibasic amino acids. Failure to thrive, hepatosplenomegaly, hematological abnormalities, and hyperammonemic crisis are major clinical features. However, there has been no reported Korean patient with LPI as of yet. We recently encountered a 3.7-yr-old Korean girl with LPI and the diagnosis was confirmed by amino acid analyses and the SLC7A7 gene analysis. Her initial chief complaint was short stature below the 3rd percentile and increased somnolence for several months. Hepatosplenomegaly was noted, as were anemia, leukopenia, elevated levels of ferritin and lactate dehydrogenase, and hyperammonemia. Lysine, arginine, and ornithine levels were low in plasma and high in urine. The patient was a homozygote with a splicing site mutation of IVS4+1G > A in the SLC7A7. With the implementation of a low protein diet, sodium benzoate, citrulline and L-carnitine supplementation, anemia, hyperferritinemia, and hyperammonemia were improved, and normal growth velocity was observed.

Early-life determinants of stunted adolescent girls and boys in Matlab, Bangladesh.

This paper presents the results of a longitudinal study, conducted in Matlab, Bangladesh, that examined to what extent the level of stunting in adolescence can be predicted by nutritional status in early childhood and maternal height. A linked set of data collected from the same individuals at two moments in time, i.e. early childhood (1988-1989) and adolescence (2001), was analyzed. The study found that the odds of being stunted in adolescence could be explained by the combined effect of being stunted in childhood and having a mother whose height was less than 145 cm. Also, girls were more likely than boys to be stunted in childhood, whereas boys were more likely than girls to be stunted in adolescence. The latter is probably attributable to differences in the pace of maturation. In terms of policy and (reproductive health) programmes, it is important to recall that adolescent girls whose height and weight were subnormal (weight <45 kg and height <145 cm) might run an obstetric risk. Following these cut-off points, 83% and 23% of 16-year-old girls in this study would face obstetric risk, respectively, for weight and height if they marry and become pregnant soon.

Una propuesta para países latinoamericanos: investigar los problemas nutricionales y el síndrome metabólico desde el inicio del embarazo / A proposal for Latin American countries: to investigate nutritional problems and the metabolic syndrome from the beginning of pregnancy

Propósito: Analizar la evidencia en la literatura mundial y chilena que sustenta el origen temprano de la obesidad y del síndrome metabólico. Método: Revisión selectiva de las publicaciones indicadas en los últimos veinte años, considerando las posibles influencias genéticas, maternas y ambientales. Resultados: La evidencia apunta a mayor presencia de sobrepeso y obesidad en los niños o adultos que tuvieron un crecimiento fetal deficiente o excesivo, seguidos de crecimiento en talla discreto o excesivo. Destacan las asociaciones del crecimiento o nutrición tempranos alterados con la hipertensión arterial y la resistencia insulínica; en un reciente estudio del crecimiento fetal restringido y la hipertensión arterial se pudieron controlar las influencias genéticas y ambientales confundentes. La nutrición materna desde la concepción tiene una importante influencia. Conclusiones: Se aprecia un claro papel de la programación metabólica alterada en el crecimiento temprano aunque es necesario desarrollar nuevos estudios de cohorte con diseño adecuado en nuestros países.

Objective: To Review the evidence from the international and Chilean literature on the early origins of the obesity epidemic and the metabolic syndrome. Methods: Selective review from the last 20 years including possible genetic and environmental influences. Results: Evidence was found for higher obesity rates in children and adults who had deficient or excessive fetal growth mainly followed by post-natal low increment in height. Strong associations between early growth alterations and insulin resistance and hypertension have been described. A recent study among Swedish twins discovered that genetic and shared environmental factors did not confound the association between birth weight and hypertension. Maternal nutrition since conception plays an important influence. Conclusions: There is important evidence for a role of metabolic programming from early growth failures. There is a great need to perform well-designed cohort studies in the Latin American countries.

The association between prenatal and or post natal growth disorder and lipid profile in adolescents aged 12 - 15 years old in Tanjungsari Subdistrict, Sumedang, West Java.

AIM: to investigate association between growth disorders in pre and post natal period and abnormal lipid profile in adolescents aged 12 -15 years old in Tanjungsari population. METHODS: a cohort study was conducted in 3350 children who were born in 1988-1990 in Tanjungsari Subdistrict, Sumedang, West Java. A complete anthropometric data since their birth were collected from October 2002-February 2003. Inclusion criteria: Children who had birth weight in the range of +/- 3 of standard deviation (SD). Post natal growth disorder based on Z score of height according to age group and height changes at the age of 0-12 months and 12-36 months. SGA criteria were determined based on cross tabulation between weight and birth length at birth. Study subjects were divided into control group, groups of pre natal, post natal and pre-postnatal growth disorder. All subjects were checked for lipid profiles. Statistical calculation used analysis of variance, t test and logistic regression. 312 subjects were included in this study, 73 were in control group, 90 subjects in postnatal, 96 subjects were in pre natal and 53 subjects were in pre-post natal growth disorder group. RESULTS: this study has not shown significant difference in risk factor of having abnormal lipid profile between normal control group and growth disorder group except for those in prenatal growth disorder group with RR = 2.375 (p = 0.014). CONCLUSION: the post natal growth disorder had not influenced lipid profile in adolescents with SGA. Recent BMI was an additional risk factor for pre-post natal growth disorder group.

Nutrición y patología pulmonar en el neonato de bajo peso al nacer / Bronchopulmonar dysplasia (BPD) and nutrition in the low birth weight neonate

La importancia de los factores nutricionales en la etiología de la displasia broncopulmonar (DBP) esta sustentada por la estrecha relación entre los factores que predisponen a esta entidad y el desarrollo de falla nutricional. El objetivo de este manuscrito es revisar las bases científicas en las cuales se fundamenta la interacción de la nutrición y el desarrollo de la función pulmonar en el recién nacido de bajo peso al nacer; discutir la evidencia proveniente de estudios clínicos y/o revisiones sistemáticas que evalúen el efecto de prácticas nutricionales tendientes a disminuir la incidencia y la gravedad de la DBP, y la evaluación y el manejo nutricional de pacientes ya afectados con esta enfermedad. Intervenciones nutricionales dirigidas a incrementar el aporte de calorías y principalmente de proteínas con restricción del aporte hídrico desde el primer día de vida, evitar déficit de antioxidantes como vitamina E y selenio, administrar altas dosis de Vitamina A por vía intramuscular, tendrían un rol en prevenir o disminuir la severidad de la DBP. El incrementar el aporte de calorías con aportes proteicos superiores a 3 gr/kg/día, limitar el uso de diuréticos y corticoides, mantener buena oxigenación, promover alimentación ad-libitum e implementar equipos de apoyo nutricional al alta, reducirían el déficit nutricional y la falla de crecimiento asociada.

Gigantism associated with slipped capital femoral epiphysis.

The etiology of slipped capital femoral epiphysis (SCFE) is unknown, though hormonal as well as mechanical factors have been implicated. We report a case of gigantism who presented with SCFE. This case provides an insight into the genesis of SCFE, which in this case was related to growth hormone excess and sex-hormone deficiency.

Desarrollo puberal y edad ósea en niños con antecedentes de desnutrición calórico-proteica grave precoz / Puberal development and bone age in children with early severe protein-energy malnutrition

La desnutrición grave y prolongada retrasa el crecimiento y desarrollo en el niño. Esto se ve objetivado en el menor tamaño corporal y el enlentecimiento dela maduración de diferentes tejidos, incluyendo el hueso. El retraso de la edad ósea alargaría el período de crecimiento recuperacional, si la situación nutricional mejorara. Se comparó, a una edad promedio de 12 años y 5 meses, el crecimiento estatural, la maduración ósea y el desarrollo puberal en 20 niños (10 niñas) que sufrieron desnutrición calórico-proteica grave precoz que requirió tratamiento hospitalario, con las de otros 20 niños de igual condición socioeconómica, edad y sexo, sin antecedentes de desnutrición. Se registraron diferencias significativas en el tamaño corporal en favor del grupo control (p<0,001) tanto entre los hombres como en las mujeres. Las edades óseas medidas en 18 niños de grupo de estudio (9 mujeres) y 17 controles (9 mujeres) mostraron un retraso leve, que no alcanzó significación, en todos los grupos. Las etapas puberales alcanzadas fueron semejantes en casos y controles para los dos sexos, independientemente del antecedente nutricional. Estos hallazgos sugieren que la desnutrición grave precoz, tratada, produce retraso en el crecimiento estatural pero no afectaría la maduración ósea y la maduración sexual

Short syndrome: report on a Brazilian girl with a deafness, gastroesophageal reflux and post-natal growth retardation

We report on a Brazilian girl with the clinical signs of SHORT syndrome. She also presented gastroesophageal reflux and evident post-natal growth retardation. The normal neuropsychological development and severe sensorineural deafness found are clearly signs of the SHORT syndrome. Clinical and genetic aspects are discussed.

Cockayne syndrome: a case with hyperinsulinemia and growth hormone deficiency

Cockayne syndrome is a rare autosomal recessive disorder of childhood characterized by cachectic dwarfism with senile-like appearance, mental retardation, photosensitive dermatitis, loss of adipose tissue, pigmentary degeneration of retina, microcephaly, deafness, skeletal and neurologic abnormalities. We describe here an 18 year old boy with Cockayne syndrome who had, in addition to the typical features of the disorder, fasting hyperinsulinemia and growth hormone deficiency.

A interaçäo entre o crescimento e o desenvolvimento / The interaction between growth and development

A importância do estudo do processo de crescimento e desenvolvimento deve-se ao fato de que a forma como esse processo se realiza pode ser usada como um indicador positivo de saúde. O estudo do crescimento das crianças está ligado, desde seus primórdios, às Ciências Naturais e à Matemática; já o desenvolvimento passou a ser objeto de interesse das Ciências Humanas. Assim, o estudo do crescimento e do desenvolvimento envolve profissionais de formaçäo diferente que utilizam instrumental diferente. Há uma multiplicidade de condiçöes que interfere, umas, no ritmo de crescimento; outras, no processo de desenvolvimento ou em ambos os processos; essas interferências podem ser de natureza biológica ou psicossocial. Tudo isso denotando que o crescimento e o desenvolvimento, enquanto campo de conhecimento, configuram uma interdisciplina. O avanço do conhecimento dependerá de interaçöes entre disciplinas ligadas à Biologia, como a Medicina e a Nutriçäo, ou às Ciências Humanas, como a Sociologia e a Psicologia, e mesmo a áreas que, per si, já säo inter-disciplinas, como a Saúde Pública. Säo apresentados exemplos de interaçöes entre crescimento e desenvolvimento, tirados da prática profissional do acompanhamento de crianças sadias, com a finalidade de suscitar reflexöes e demonstrar a importância da abordagem multidisciplinar do crescimento e do desenvolvimento.

Estado nutricional de niños preescolares guatemaltecos hospitalizados por infecciones respiratorias agudas / Nutritional status of Guatemalan preschool children hospitalized for acute respiratory infections

Se determinó el estado nutricional (peso-para-edad, talla-para/edad y peso-para/talla) de 678 niños de cero a 59 meses de edad admitidos con síntomas de infección respiratoria aguda al Hospital General San Juan de Dios, de la ciudad de Guatemala. De todos los casos, 557 (82.2%) se clasificaron como broncopneumoníañ 62(9.1) como pneumonía y 43 (6.3%) como bronquiolitis. Quinientos setenta (82.6%) procedían de la zona urbana de la capital y 118 (17.4%) de los municipios del departamento de Guatemala. Se encontró que 188 (27.8%) tenían deficiencia de peso-para-edadñ 176 (25.9%) acusaban deficiencia de talla-para-edad, y 84 (12.4%) mostraron bajo peso-para-talla. En general, los niños procedentes de los municipios mostraron las proporciones más altas de desnutrición, aunque existen zonas de la capital en donde la desnutrición es altamente prevalente. Setenta y ocho (14.0%) de los casos de broncopneumonía tenían deficiencia de peso/talla. El monitoreo del estado nutricional de pacientes admitidos a salas de pediatría por problemas infeccisos puede aportar valiosa información, no sólo para su manejo sino también para la educación en salud de los padres de familia

Cutis laxa e retardo do desenvolvimento: estudo de um caso e análise da variabilidade da síndrome / Cutis laxa and growth retardation: study of a case and analysis of syndrome's variabilities

O presente trabalho relata um caso cutis laxa associado a retardo do desenvolvimento. Esta é a primeira descriçäo desta entidade clínica no Brasil