Oxidative and Antioxidative Stress Status in Children with Inflammatory Bowel Disease as a Result of a Chronic Inflammatory Process.

Oxidative stress (OS) has been recently implicated in the disease pathogenesis in inflammatory bowel disease (IBD). The aim of the study was to evaluate oxidative and antioxidative stress status and the risk of the atherosclerotic process in children with IBD and functional gastrointestinal disorders (FGID). The prospective study included a group of 71 children during a period of 2 years. In all children, laboratory tests were performed and intima-media complex in the carotid artery was measured (IMC). Low values of OS were more frequent in children with IBD than in the FGID group. The average concentration of oxidized lipoprotein with average density (oxLDL) was lower in patients with IBD. Among patients with IBD, higher concentrations of oxLDL were recorded in patients with longer-duration disease and with higher concentrations of total cholesterol. In the IBD group, more often, higher concentrations of anti-oxLDL were recorded among patients with longer-duration disease. The obtained results did not support the hypothesis of total antioxidant capacity depletion and greater overall OS in patients with IBD. Patients with IBD with a longer duration of the disease have higher concentrations of oxLDL and anti-oxLDL.

Renal function in children treated for central nervous system malignancies.

AIM: The aim of the study was to evaluate renal function and to assess the usefulness of the following nephrotoxicity markers: cystatin C (CYS C), beta-2 microglobulin (B2MG) and neutrophil gelatinase-associated lipocalin (NGAL) in 38 (18 girls, 20 boys) children previously treated for central nervous system malignancy. MATERIAL: Median age at evaluation was 13.7 years (range 2.1-22 years). The mean follow-up time after the completion of chemotherapy was 3.2 years (range 0.16-6.5 years). RESULTS: Subclinical chronic kidney disease (estimated glomerular filtration rate: eGFR 90-60 ml/min/1.73 m(2)) was found in 22 patients (58 %), while renal insufficiency (eGFR 30-60 ml/min/1.73 m(2)) was found in six children (16 %). It has been demonstrated statistically significant negative correlation between the eGFR and cystatin C concentration (p < 0.0001) and eGFR and beta-2 microglobulin concentration (p < 0.02). Conversely, there was no correlation between eGFR and NGAL. Thirteen children (34 %) developed drug-induced tubulopathy: decreased tubular reabsorption of phosphate (TRP) and renal tubular threshold for phosphate (Tmp/GFR). CONCLUSION: Children treated for CNS tumours often develop drug-induced chronic renal disease, involving the glomeruli and/or renal tubules. Cystatin C and beta-2 microglobulin seemed to be good markers for chronic kidney damage in these patients, which is probably not true for NGAL.

Diagnostic problems in cystic fibrosis - specific characteristics of a group of infants and young children diagnosed positive through neonatal screening, in whom cystic fibrosis had not been diagnosed.

INTRODUCTION: Neonatal cystic fibrosis screening contributes to an early diagnosis of cystic fibrosis and to implementing appropriate therapeutic management. Long-standing screening tests have made it possible to identify a group of newborns in whom the diagnosis was ambiguous and required further specialised tests. AIM: The aim is to present cases of patients with a positive result of newborn screening for cystic fibrosis who were found to be carriers of the mutation in both alleles, however the lack of clinical symptoms and correct sweat testing values did not lead doctors to diagnosing cystic fibrosis and by the same token implementing the treatment. MATERIAL AND METHODS: The analysis encompassed a group of 22 infants and children 3 months to 3 years of age, in whom, in spite of a positive result of newborn screening for cystic fibrosis and the presence of 2 mutations in the CFTR gene, the diagnosis of cystic fibrosis was not made, and appropriate treatment was not administered because of diagnostic doubts (due to correct concentration of chlorides in sweat, correct IRT level and lack of clinical signs of cystic fibrosis). The control group consisted of 55 children treated in our centre, in whom neonatal screening for cystic fibrosis was positive and the diagnosis was confirmed by genetic testing, sweat chloride testing and IRT concentration. RESULTS: There were no differences in birth body weight between the groups. The differences in chlorideion levels in sweat secretion tests and mean IRT values were statistically significant and were: 97.5 for the control group and 26.4 for the test group. At the present time there are no clinical symptoms to give a diagnosis of cystic fibrosis and start treatment in the test group. CONCLUSIONS: Newborn screening contributes not only to an early diagnosis of cystic fibrosis but also to CFTR-related metabolic syndromes (CRMS), which is a phenomenon requiring further observation. This fact constitutes a definite psychological problem for the parents of these patients. .

Concentrations of tumour necrosis factor-α and its soluble receptors in the serum of teenagers with atherosclerosis risk factors: obesity or obesity combined with hypertension.

INTRODUCTION: Obesity and hypertension are recognised risk factors for the development of atherosclerosis. It has not been proven whether their co-existence increases the synthesis of pro-inflammatory TNF-α and what the levels of soluble receptors of this cytokine (sTNF-R) are. This study is aimed to investigate whether there exists a relationship between TNF-α and sTNF-R concentrations in blood serum with the occurrence of obesity or obesity combined with primary hypertension in teenagers. MATERIAL AND METHOD: 68 persons, aged 9-17, including 32 persons with primary obesity (Group I) and 36 with primary obesity combined with primary hypertension (Group II). TNF-α (pg/mL) and sTNF-R (ng/mL) concentrations were determined in serum samples using the ELISA method with sets of reagents manufactured by Bender Med Systems GmbH. RESULTS: No significant differences in TNF-α, sTNF-R, glucose or insulin concentrations were found between Group I and Group II. These concentrations were not correlated with the age and the nutritional status of the patients or with each other in either of the groups. CONCLUSION: Both obese teenagers and teenagers exhibiting obesity combined with hypertension (as two atherosclerosis risk factors) are characterised by comparable concentrations of TNF-α and its soluble receptors.

Evaluation of certain constituents of antioxidant defense in youth treated in the past for steroid-sensitive idiopathic nephrotic syndrome.

Disorders of lipid metabolism and antioxidant defense capacity reported during idiopathic nephrotic syndrome (INS) exacerbations are known. The aim of this study was to evaluate constituents of antioxidant defense [total antioxidant potential: ferric-reducing antioxidant power (FRAP), paraoxonase-1 (PON-1), tocopherols, ascorbic acid] in patients formerly treated for INS. The studied group consisted of 30 patients (20 males and 10 females) treated 4-15 years ago for INS. The control group consisted of 30 healthy teenagers. There were no statistically significant differences in PON-1 activity (156.4 +/- 97.1 vs 137.7 +/- 80.2 U/l), alpha-tocopherol levels (23.9 +/- 7.3 vs 22.4 +/- 3.2 micromol/l) and sum of beta- and gamma-tocopherols (2.1 +/- 1.0 vs 2.3 +/- 0.6 micromol/l), and in FRAP (484.9 +/- 87.2 vs 452.8 +/- 76.9 micromol/l) between groups. In the study group, a significantly lower concentration of ascorbic acid (53.0 +/- 20.8 vs 69.4 +/- 16 micromol/l; p < 0.002), decreased values of alpha-tocopherol/cholesterol (4.9 +/- 0.7 vs 5.5 +/- 1.2; p = 0.03), and total tocopherol/cholesterol (5.3 +/- 0.8 vs 6.1 +/- 1.4; p = 0.016) ratios were observed. A positive correlation between tocopherol/total cholesterol (TCh) (r = 0.41; p < 0.05) and alpha-tocopherol/TCh (r = 0.50; p < 0.001) ratios and INS relapse frequency was reported. The relationship between the study parameters and group of variables (relapse frequency, duration of the last remission, age, gender) was tested using the multiple linear regression analysis. The results of this study suggest that the nonenzymatic antioxidant defense in young persons formerly treated for INS is weaker than in their healthy counterparts.

Atherosclerosis risk factors in young patients formerly treated for idiopathic nephrotic syndrome.

UNLABELLED: A total of 30 patients (ten female/20 male), 9 years to 22 years old (mean age 17.3 years) and 30 healthy teenage controls (mean age 16.4 years) were included in our study. The patients had steroid-sensitive idiopathic nephrotic syndrome (INS) and had completed steroid therapy 4 years to 15 years ago. Height and weight, body mass index (BMI), body composition, and intima-media thickness (IMT) were determined, as were levels of total cholesterol (TCh), low-density lipoprotein cholesterol (LDL-Ch), high-density lipoprotein cholesterol (HDL-Ch), triacylglycerols (TAGs), homocysteine (HCY), and high-sensitivity C-reactive protein (hsCRP). We did not observe any differences between the study and control groups in IMT (0.47 +/- 0.1 vs 0.46 +/- 0.1 mm) and body composition (fat tissue and water content). Differences in HDL-Ch and hsCRP levels between groups were not significant. In the study group we found significantly higher TCh levels (187.6 +/- 57.2 mg/dl vs 158.8 +/- 25.7 mg/dl; P = 0.012), LDL-Ch (115.9 +/- 63.7 mg/dl vs 79.4 +/- 25.4 mg/dl; P = 0.005), HCY (12.3 +/- 7.7 micromol/l vs 7.6 +/- 1.6 micromol/dl; P < 0.001), apolipoprotein B (ApoB) (113.6 +/- 30.0 mg/dl vs 78.7 +/- 13.6 mg/dl; P < 0.001) and ApoA1 (203.5 +/- 50.8 mg/dl vs 156.5 +/- 12.4 mg/dl; P < 0.001) levels. Multi-factor analysis of the influence of independent factors (number of recurrences, duration of remission, age, gender, and BMI) on the parameters under investigation indicated a positive correlation between IMT and the number of recurrences. CONCLUSIONS: 1. Patients treated for idiopathic nephrotic syndrome in the past should undergo regular laboratory tests of atherosclerosis risk factors, including not only cholesterol and its fractions, but also ApoA1, ApoB and HCY. 2. It is necessary to continue systematic check-ups of the intima-media thickness of the carotid arteries among young patients with anamnesis of INS, especially among patients who suffered from numerous relapses of this disease.

[Assessment of association of birth weight and existence of hypertension in children and adolescents normostenic, obese or with metabolic syndrome]. / Masa urodzeniowa ciala a wystepowanie nadcisnienia tetniczego w grupie dzieci i mlodziezy normostenicznej, z otyloscia lub z cechami zespolu metabolicznego.

UNLABELLED: It has been proved that Low Birth Weight (LBW) is a predisposing factor of elevated blood pressure in children. The aim of our study was to analyze birth weight of patients with diagnosed hypertension (HT). There has been 114 children, 6 to 17 years old, included into our study. We decided to divide them into 3 following groups: Group I--normal body mass and HT (51 children); Group II--metabolic syndrome (MS) with HT (32 children); Group III--overweight and obese children with HT (31 children). At 85% of all patients HT was diagnosed after performing ABPM. Statistically significant difference of birth weight was observed between patients with normal body mass (I) and those with overweight or obesity (III) (p<0,01). The most number of children with LBW (<2500 g) was observed in Group I (15.7%) and Group II (12.5%). It was observed that obese children with HT had had normal or high birth weigh (96.8%). CONCLUSION: 1. The frequency of low birth weight is similar in normostenic children with hipertension and children with metabolic syndrome. 2. The birth weight higher than 4000 g is more frequent in obesy hipertensive children and children with metabolic syndrome than in normo-stenic patients with hipertension.

[Characteristics of metabolic syndrome in children and adolescents with arterial hypertension]. / Cechy zespolu metabolicznego u dzieci i mlodziezy z nadcisnieniem tetniczym.

UNLABELLED: Among the components of metabolic syndrome (MS) obesity, arterial hypertension, insulin resistance, abnormal plasma lipoproteins balance: decreased HDL concentration and increased level of triglycerides are mentioned. In diagnosis of MS the coexistence of three of these criteria is obligatory. MS is frequently diagnosed in adult patients. The aim of the study was the evaluation of MS components in the group of 118 children with arterial hypertension (HT) who were hospitalized in Pediatric Department of Silesian Medical University in Bytom. The criterium of qualification to HT group was: blood pressure higher than 97 percentile in at least 20% of ABPM measurements. BMI, glucose blood concentration, HDL levels, triglycerides (TG) levels, uric acid concentration were also analyzed. Thirty children (25%) presented at least three of MS components: 16 (53%) - three of them, 12 (40%) - four of them and 2 (6,7%) all of them. Mean age of children with MS was 13,5 years, the youngest was 6 years old. BMI of 83% children with metabolic syndrome was considerably above 97 percentile. 53% had low HDL levels and 80% high TG levels. TG levels highly increased above normal values for sex and age. Mean TG concentration was 2,26 mmol/l. 83% of our patients with MS had primary (idiopathic) arterial hypertension, at 13,3% arterial hypertension of renal cause. CONCLUSIONS: The study revealed that all children with arterial hypertension especially those with primary HT should be evaluated for MS in order to start the early prevention of cardiovascular disease.