Accelerated Weight Gain Subsequent to Postnatal Slow Weight Gain and Overweight Risk in Early Childhood: A Nested Case-Control Study.

BACKGROUND: The effects of accelerated weight gain (AWG) immediately after a postnatal slow weight gain (PSWG) on the risk of later overweight is unknown. The objective of this study was to assess the relationship between AWG after PSWG and overweight risk at 3 years of age. METHODS: This nested case-control study included 255 subjects born at term, appropriate for gestational age, and with normal birth weight but PSWG (< 0.67 SD score) until 3-4 months of age. Overweight cases at 3 years of age were defined according to International Obesity Task Force criteria. The association between AWG after PSWG and overweight status at age 3 years was analyzed by the Fisher's exact, Breslow-Day, and Mantel-Haenszel tests. RESULTS: Seven of the subjects that showed AWG after PSWG were deemed overweight at age 3. An AWG from 6-9 to 17-20 months after PSWG during the first 3-4 months of life had the most significant association with overweight status at 3 years of age (adjusted OR 10.06, 95% CI 1.74-58.01, p value: 0.0022). CONCLUSIONS: AWG immediately after PSWG, even occurring at only 1 of 3 interval from 3-4 to 6-9 months, from 6-9 to 17-20 months, and 17-20 months to 3 years after PSWG, leads to an overweight status at 3 years of age. Monitoring weight growth after PSWG may help identify AWG and later overweight risk.

Elevation of Serum Levels of High-Sensitivity Procalcitonin, C-reactive Protein, and Amyloid A in a Prepubertal Child with Mumps Orchitis.

BACKGROUND: Serum CRP concentrations are significantly elevated at the acute phase in patients with mumps orchitis, but little is known currently about other inflammatory biomarkers. METHODS: We report the measurements of serum inflammatory biomarkers [high-sensitivity procalcitonin (hs-PCT), C-reactive protein (CRP) and amyloid A] in a child with mumps orchitis. RESULTS: The patient's serum levels of CRP, hs-PCT, and amyloid A were highly increased at the acute phase, but returned to normal levels at convalescence. CONCLUSIONS: This case suggests that hs-PCT and amyloid A may not be useful for distinguishing between mumps orchitis accompanied by highly elevated serum concentrations of CRP and systemic bacterial infections.

Chest circumference in infancy predicts obesity in 3-year-old children.

The purpose of this study was to investigate the associations between chest circumference in infancy and rapid growth or obesity at 3 years of age. We conducted a retrospective observational study of 1353 children in Kumamoto, Japan. Data collected included chest circumference, head circumference, weight, and body mass index. The area under the receiver operating characteristic curves for chest circumference were analyzed to determine the ability of this index to identify obesity at 3 years of age. Chest circumference at 3-4 months of age and increases in chest circumference during the first 3-4 months of life had higher mean standard deviation scores for rapid growth than for slow or no change in growth (p<0.05). Chest circumference and the increase in chest circumference were also positively correlated with rapid weight gain, and were associated with obesity at 3 years of age. The area under the curve for chest circumference was significantly different from the area under the curve for weight z-score at 6-9 months but not for weight z-score at 3-4 months. In conclusion, we found that chest circumference is associated with obesity in young children, and is positively correlated with rapid growth. Therefore, chest circumference may be a useful marker for rapid growth, and may help clinicians to identify obese children at 3 years of age.

Taller stature after postnatal rapid weight gain in early infancy predicts overweight status at age 3.

AIM: To evaluate whether postnatal rapid weight gain in early infancy is associated with subsequent tall stature and being overweight at age 3, and taller stature after postnatal rapid weight gain predicts overweight status at age 3. METHODS: Data from a retrospective cohort study (time period 2003-2004, total number = 1353 subjects in Kumamoto, Japan) were used. The rate of weight gain during the first 3-4 months was calculated as 100 g/month, and postnatal rapid and slow growth were calculated by using weight standard deviation (SD). Overweight status at 3 years of age was determined according to the definition of the International Obesity Task Force. RESULTS: In total, 4.7% of subjects were overweight at age 3. Postnatal rapid weight gain, associated with height increases until age 3 (p < 0.0001), and the rate of weight gain were significant risk factors for being overweight in children at age 3. Taller heights at 6-9 months and 17-20 months of age following postnatal rapid weight gain were associated with overweight status at age 3 (p < 0.05). CONCLUSION: Taller stature following postnatal rapid weight gain in early infancy predicts overweight status at age 3; additionally, rapid infancy weight gain contributes to the acceleration of statural growth in overweight children.

An unusual case of thrombocytosis associated with concurrent cytomegalovirus and respiratory syncytial virus infection in an immunocompetent infant: possible roles of thrombopoietin and interleukin-6.

This is the case study of concurrent cytomegalovirus and respiratory syncytial virus infection in an infant who showed thrombocytosis, liver dysfunction and bronchiolitis. The combination of thrombocytosis with this co-infection is causally related to elevated levels of thrombopoietin and interleukin-6. This study represents the first such case ever recorded.