Influence of obesity on nocturnal oxygen saturation in young children.

UNLABELLED: Obesity is increasing worldwide and it is accompanied by major health effects. In adults and school-aged children, obesity is associated with decreased respiratory function, which may lead to disturbed sleeping and subsequently difficulties in concentration and behavioural disorders. The evidence for the association between obesity and decreased respiratory function in younger children is scarce. To explore the association between body weight and nocturnal respiratory function in young children, 1 to 3 years old, nocturnal pulse oximetry was performed at home. Children with tonsillar hypertrophy were excluded. Percentage of time with oxygen saturation (SpO(2)) <95 % was measured and its association with body mass index (BMI) for age z scores was analysed. Pulse oximetric data of 51 children, including 18 children with a BMI for age above +2 standard deviations, were obtained for this study. Linear regression analysis, correction for gender and parental smoking, showed a positive association between the natural logarithm of SpO(2) <95 % and BMI for age z score [regression coefficient (ß) 0.19, 95 % confidence interval 0.00-0.39]. CONCLUSION: In young children, higher body weight is associated with a decrease in nocturnal oxygen saturation.

Doença celíaca é super-representada em pacientes com constipação / Celiac disease is overrepresented in patients with constipation

OBJETIVO: Tem sido sugerido que pacientes com constipação sejam triados para doença celíaca. Da mesma forma, recomenda-se a investigação desses pacientes para hipotiroidismo e hipercalcemia. Contudo, nenhuma evidência para essas recomendações está disponível até o momento. Assim, propusemos-nos determinar a prevalência de doença celíaca, hipotiroidismo e hipercalcemia em crianças com constipação. MÉTODOS: Estudo de coorte prospectivo com 370 pacientes consecutivos que preencheram os critérios de Roma III para constipação. Esses pacientes foram encaminhados por um clínico geral a um pediatra devido ao fracasso no tratamento com laxantes. RESULTADOS: A biópsia comprovou doença celíaca em sete desses pacientes. Isso é significativamente mais alto (p < 0,001) do que a prevalência de 1:198 de doença celíaca nos Países Baixos. Dois pacientes tinham tiroidite autoimune. Nenhum paciente tinha hipercalcemia. CONCLUSÕES: Conclui-se que a doença celíaca é significativamente super-representada em pacientes com constipação encaminhados por um clínico geral a um pediatra devido ao fracasso no tratamento com laxantes. Todos esses pacientes devem, portanto, ser triados para doença celíaca.

OBJECTIVE: It is suggested that patients with constipation should be screened for celiac disease. Similarly, it is recommended to investigate these patients for hypothyroidism and hypercalcemia. However, no evidence for these recommendations is available so far. We therefore set out to determine the prevalence of celiac disease, hypothyroidism, and hypercalcemia in children with constipation. METHODS: Prospective cohort study of 370 consecutive patients who met the Rome III criteria for constipation. These patients were referred by a general practitioner to a pediatrician because of failure of laxative treatment. RESULTS: Seven of these patients had biopsy-proven celiac disease. This is significantly higher (p < 0.001) than the 1:198 prevalence of celiac disease in the Netherlands. Two patients had auto-immune thyroiditis. No patient had hypercalcemia. CONCLUSIONS: We conclude that celiac disease is significantly overrepresented in patients with constipation who are referred by a general practitioner to a pediatrician because of failure of laxative treatment. All such patients should, therefore, be screened for celiac disease.

Celiac disease is overrepresented in patients with constipation.

OBJECTIVE: It is suggested that patients with constipation should be screened for celiac disease. Similarly, it is recommended to investigate these patients for hypothyroidism and hypercalcemia. However, no evidence for these recommendations is available so far. We therefore set out to determine the prevalence of celiac disease, hypothyroidism, and hypercalcemia in children with constipation. METHODS: Prospective cohort study of 370 consecutive patients who met the Rome III criteria for constipation. These patients were referred by a general practitioner to a pediatrician because of failure of laxative treatment. RESULTS: Seven of these patients had biopsy-proven celiac disease. This is significantly higher (p < 0.001) than the 1:198 prevalence of celiac disease in the Netherlands. Two patients had auto-immune thyroiditis. No patient had hypercalcemia. CONCLUSIONS: We conclude that celiac disease is significantly overrepresented in patients with constipation who are referred by a general practitioner to a pediatrician because of failure of laxative treatment. All such patients should, therefore, be screened for celiac disease.

[Diagnostic image; a neonate with a blueish, swollen scrotum]. / Een zuigeling met een blauw, gezwollen scrotum.

A blueish, swollen scrotum in a neonate appeared to be caused by a hydrocele, as shown by the typical transillumination.